Racial and Ethnic Disparities in Referral Rejection from Postacute Care Facilities among People with Opioid Use Disorder in Massachusetts.

Objectives: The aim of the study was to examine the association between Black, White, and Hispanic or Latino race and ethnicity and referral rejection from private postacute care facilities among hospitalized individuals with opioid use disorder (OUD).

Methods: In this retrospective cohort study, we linked electronic postacute care referrals from Boston Medical Center in 2018 to electronic medical record data, which we used to ascertain OUD status and race and ethnicity. Using multivariable logistic regression, we examined the association between Black, White, and Hispanic or Latino race and ethnicity and referral rejection, adjusting for individual-level characteristics including medication for opioid use disorder treatment type and for facility-level factors using facility random effects.

Improving racial/ethnic health equity and naloxone access among people at risk for opioid overdose: A simulation modeling analysis of community-based naloxone distribution strategies in Massachusetts, United States.

Background And Aims: During the COVID-19 pandemic, there was a surge in opioid overdose deaths (OODs) in Massachusetts, USA, particularly among Black and Hispanic/Latinx populations. Despite the increasing racial and ethnic disparities in OODs, there was no compensatory increase in naloxone distributed to these groups. We aimed to evaluate two community-based naloxone expansion strategies, with the objective of identifying approaches that could mitigate mortality and racial and ethnic disparities in OODs.

Anatomical eModule Curriculum: Perceptions of Undergraduate Medical Students Amidst Limited Experiential Laboratory Learning.

Introduction: Over the past several years, undergraduate medical students were subject to variable learning environments amidst pandemic-related restrictions, challenging long-established experiential learning approaches. Concurrently, health science institutions have been revisiting the value (or lack thereof) of human body dissection. This study examined student experience using a supplemental gross anatomy eModule before, during, and after limitation of in-person experiential gross anatomy curriculum and which eModule attributes students find valuable.

Pharmacy Naloxone Standing Order and Community Opioid Fatality Rates Over Time.

Importance: Despite the proliferation of pharmacy standing-order naloxone dispensing across many US states before the change to over-the-counter status, few policy analyses have evaluated the implementation of pharmacy naloxone standing orders in addressing opioid overdose fatality among communities.

Objective: To determine whether the implementation of pharmacy standing-order naloxone was associated with lower opioid fatality rates compared with communities without pharmacies with standing-order naloxone.

Design, Setting, And Participants: This retrospective multisite study was conducted with an interrupted time series analysis across 351 municipalities in Massachusetts over 24 quarters (from January 1, 2013, through December 31, 2018).

All-Cause Mortality and Cause-Specific Death in U.S. Long-Lived Siblings: Data From the Long Life Family Study.

Background: This study compared the mortality risk of long-lived siblings with the U.S. population average and their spouse controls, and investigated the leading causes of death and the familial effect in death pattern.

Assessing the state of obesity care: Quality, access, guidelines, and standards.

Background: An international panel of obesity medicine experts from multiple professional organizations examined patterns of obesity care and current obesity treatment guidelines to identify areas requiring updating in response to emerging science and clinical evidence.

Aims: The panel focused on multiple medical health and societal issues influencing effective treatment of obesity and identified several unmet needs in the definition, assessment, and care of obesity.

Methods: The panel was held in Leesburg, Virginia in September 2019.

Characterizing the Association Between Traumatic Brain Injury and Discontinuation of Medications for Opioid Use Disorder in a Commercially Insured Adult Population.

Objective: Extending prior research that has found that people with traumatic brain injury (TBI) experience worse substance use treatment outcomes, we examined whether history of TBI was associated with discontinuation of medication to treat opioid use disorder (MOUD), an indicator of receiving evidence-based treatment.

Setting: We used MarketScan claims data to capture inpatient, outpatient, and retail pharmacy utilization from large employers in all 50 states from 2016 to 2019.

Participants: We identified adults aged 18 to 64 initiating non-methadone MOUD (ie, buprenorphine, injectable naltrexone, and oral naltrexone) in 2016-2019.

Perception and Correlates of Opioid Overdose Risk Among Overdose Survivors Who Use Nonprescribed Opioids in San Francisco and Boston.

Background: Understanding opioid overdose risk perception may inform overdose prevention strategies.

Methods: We used baseline data from a randomized overdose prevention trial, in San Francisco, CA, and Boston, MA, among people who used nonprescribed opioids, survived an overdose in the past 3 years, and had received naloxone. Participants were asked how likely they were to overdose in the next 4 months.

Prescribe to Save Lives: An Intervention to Increase Naloxone Prescribing Among HIV Clinicians.

Objectives: Overdose is a major cause of preventable death among persons living with HIV. This study aimed to increase HIV clinicians' naloxone prescribing, which can reduce overdose mortality.

Methods: We enrolled 22 Ryan White-funded HIV practices and implemented onsite, peer-to-peer training, posttraining academic detailing, and pharmacy peer-to-peer contact around naloxone prescribing in a nonrandomized stepped wedge design.

Changes to opioid overdose deaths and community naloxone access among Black, Hispanic and White people from 2016 to 2021 with the onset of the COVID-19 pandemic: An interrupted time-series analysis in Massachusetts, USA.

Background And Aims: The onset of the coronavirus disease 2019 (COVID-19) pandemic was associated with a surge in opioid overdose deaths in Massachusetts, particularly affecting racial and ethnic minority communities. We aimed to compare the impact of the pandemic on opioid overdose fatalities and naloxone distribution from community-based programs across racial and ethnic groups in Massachusetts.

Design: Interrupted time-series.

The police paradox: A qualitative study of post-overdose outreach program implementation through public health-public safety partnerships in Massachusetts.

Background: Post-overdose outreach has emerged in the United States as an increasingly common response to non-fatal overdose. This qualitative study investigates the implementation of such programs through public health-public safety partnerships in Massachusetts.

Methods: We conducted semi-structured interviews with post-overdose outreach team members, overdose survivors, and family members who received outreach.

Disparities in use of physical restraints at an urban, minority-serving hospital emergency department.

Background: Recent reports have identified associations between patient race and ethnicity and use of physical restraint while receiving care in the emergency department (ED). However, no study has assessed this relationship in hospitals primarily treating patients of color and underserved populations. The primary objective of this study was to evaluate the association between race/ethnicity and the use of restraints in an ED population at a minority-serving, safety-net institution.

Civil commitment perspectives and experiences among friends and family of people who use illicit opioids in Massachusetts, USA.

Background: Civil commitment statutes allow qualified individuals to petition for court-mandated commitment for someone with a substance use disorder (SUD). Despite a lack of empirical evidence showing efficacy of involuntary commitment, these statutes are prevalent worldwide. We examined perspectives on civil commitment among family members and close friends of people who use illicit opioids in Massachusetts, U.

Smoked drug use in patients with TB is associated with higher bacterial burden.

Smoking of illicit drugs may lead to more rapid TB disease progression or late treatment presentation, yet research on this topic is scant. We examined the association between smoked drug use and bacterial burden among patients newly initiated on drug-susceptible TB (DS-TB) therapy. Data from 303 participants initiating DS-TB treatment in the Western Cape Province, South Africa, were analyzed.

Scanner-Independent MyoMapNet for Accelerated Cardiac MRI T Mapping Across Vendors and Field Strengths.

Background: In cardiac T mapping, a series of T -weighted (T w) images are collected and numerically fitted to a two or three-parameter model of the signal recovery to estimate voxel-wise T values. To reduce the scan time, one can collect fewer T w images, albeit at the cost of precision or/and accuracy. Recently, the feasibility of using a neural network instead of conventional two- or three-parameter fit modeling has been demonstrated.

Population-Level Health Effects of Involuntary Displacement of People Experiencing Unsheltered Homelessness Who Inject Drugs in US Cities.

Importance: At least 500 000 people in the US experience homelessness nightly. More than 30% of people experiencing homelessness also have a substance use disorder. Involuntary displacement is a common practice in responding to unsheltered people experiencing homelessness.

Promoting Housing-Based Asset Building Programs in Healthcare.

Objectives: Wealth building programs remain underutilized, and Medical Financial Partnerships serve as a potential solution. We aimed to assess the reach and adoption of an underutilized asset building program, Family Self Sufficiency, with a national uptake of 3%, when integrated into a healthcare system.

Methods: First, a hospital-affiliated "known provider" introduced Family Self Sufficiency to clinic patients.

Drinking Water From Private Wells and Risks to Children.

Drinking water for approximately 23 million US households is obtained from private wells. These wells can become contaminated by pollutant chemicals or pathogenic organisms, leading to significant illness. Although the US Environmental Protection Agency and all states offer guidance for construction, maintenance, and testing of private wells, most states only regulate the construction of new private water wells.

Drinking Water From Private Wells and Risks to Children.

Drinking water for >23 million US households is obtained from private wells. These wells can become contaminated by chemicals, naturally occurring toxic substances, or pathogenic organisms that can cause illness in children. Although the US Environmental Protection Agency and most states offer some guidance for the construction, maintenance, and testing of private wells, most states only regulate the construction of new private water wells.

Ventricular Tachycardia in a Pediatric Patient with High-Risk Thrombotic Thrombocytopenia Purpura.

An 8-year-old previously healthy male was diagnosed with thrombotic thrombocytopenic purpura (TTP) and increased serum cardiac troponin I. Telemetry recorded non-sustained ventricular tachycardia, without ST-segment changes or other abnormalities on serial electrocardiogram. This case illustrates that cardiac monitoring by telemetry should be considered in high-risk TTP with elevated cardiac troponin.