Sources of Information and Health Care Experiences Related to COVID-19 among Women Involved in Criminal Legal System in Three U.S. Cities

Women in the United States criminal legal (CL) system are at the nexus of several drivers of the COVID-19 pandemic, including incarceration, poverty, chronic illness and racism. There are 1.25 million women incarcerated or on community supervision (probation or parole) in the U.S. We present findings regarding the impact of COVID-19 on women in the CL system (N=344) during the early days of the pandemic. Participants were drawn from community settings in an ongoing study of cervical cancer risk in three U.S. cities: Birmingham, Alabama, Oakland, California and Kansas City, which straddles the states of Kansas and Missouri. Regional differences were found in COVID-19 testing and perceived susceptibility to the virus, but not in COVID-related disruptions to health care. We found differences by race/ethnicity in trusted sources of information about COVID. Black women had higher odds of choosing TV as their most trusted source of information, while White women were more likely to cite government or social service agencies as their most trusted source. Notably, 15% of women said they did not trust any source of information regarding COVID-19. COVID-19 disproportionately impacts populations with high levels of mistrust towards medical and government institutions, a result of the twin legacies of medical mistreatment and structural racism. Our findings underscore the need for innovative strategies to reach these groups with accurate and timely information.

A search for strategies to engage women in substance abuse treatment

Retention is a well-documented predictor of favorable outcome of substance abuse treatment. In order to remain in treatment, clients must initially engage in the treatment process. This issue is a particular challenge for clinicians who continually seek motivational strategies that will draw each individual into the treatment process. Few engagement strategies have been specifically tested to determine their efficacy. The results of this study indicate that outpatient clients who received engagement services during the intake period showed increased use of these services, relative to a comparison group, throughout the treatment process. In addition, tangible engagement services provided to women during the intake period for outpatient substance abuse treatment had no significant effect on the rates of admission, discharge, and service utilization.

Assessing the needs of substance abusing women. Psychometric data on the psychosocial history

The Psychosocial History (PSH) is a comprehensive multidisciplinary interview designed to assess the status, history, and needs of women in substance abuse treatment. The PSH retains the fundamental scoring structure of the Addiction Severity Index (ASI), while adding supplemental questions considered clinically useful and relevant for predicting outcomes. The present study examined the psychometric properties and general utility of both instruments with a sample of women enrolled in substance abuse treatment. Initially, the instruments were tested independently and found to have excellent test-retest reliability and acceptable internal consistency. A reliability trial between the instruments found that the composite scores (CS) of the ASI and PSH yielded satisfactory correlations among four of the six CS domains. The PSH had higher CS scores than the ASI across domains, which may reflect the comprehensive nature of the PSH items that prompt greater disclosure of problems and needs. Validity analyses showed significant correlations of PSH and ASI psychiatric CSs with Symptom Checklist-90-Revised totals. These results suggest that the PSH yields reliable and valid assessment data similar to the ASI. Moreover, the PSH provides a more comprehensive assessment than the ASI in the area of pregnancy, family issues, and victimization.

Biopsychosocial characteristics and treatment outcomes of pregnant cocaine-dependent women in residential and outpatient substance abuse treatment

The purpose of this descriptive study was to compare the characteristics and treatment outcomes of pregnant cocaine-dependent women and their infants enrolled in residential (N=32) and outpatient (N=32) treatment settings. Biopsychosocial characteristics and issues that influenced the women's multiple treatment outcomes are highlighted. Comparisons of retention and infant birth outcomes found no significant differences between treatment programs, whereas abstinence and patterns of attrition showed meaningful differences favoring residential treatment. Further research is needed to evaluate whether the reported treatment outcomes are markers of improved life functioning that hold promise for the women in treatment, their families and the community.

Methylphenidate in the treatment of coma

While there is significant morbidity and mortality involving patients in semicomatose and comatose states, the care of such patients has traditionally been limited to supportive measures. We report two cases of patients treated with methylphenidate hydrochloride: the first, a patient in a semicomatose state resulting from traumatic brain injury, and the second, a patient in a comatose state secondary to a subdural hematoma that occurred after a fall. Treatment with methylphenidate may provide neurostimulations by augmenting the activity of injured neuronal tissue within the reticular activating system, and by amplifying the net effect of the reduced number of viable neurons. Methylphenidate is a low-cost, potentially efficacious intervention for reducing the duration of comas, for preventing life-threatening and costly complications of prolonged unconsciousness, and for promoting early ambulation and recovery. Further research using more rigorous research designs to ascertain the effectiveness of methylphenidate in the treatment of patients in semicomatose and comatose states is needed.

Factors influencing the relationship between a newborn assessment of gestational maturity and the gestational age interval

This study examines the correlation and agreement between the calculated 'gestational interval' from the date of last menstrual period (LMP) and the Ballard newborn assessment of gestational maturity. It then investigates selected maternal socio-demographic, prenatal, intrapartum and infant factors which may account for differences between these two gestational age determination methods. Single live-born deliveries (n = 10,794) were selected from a 1982-1986 medical university perinatal information data system for analysis. The Ballard assessment overestimates the LMP at earlier gestational ages and underestimates in the post-term range. The discrepancy between LMP and Ballard varies across the range of gestational age values and the extent of variation differs by several maternal and infant risk factors. These findings suggest considerable bias may result from the indiscriminate case mixing of LMP and Ballard values for use in gestational age research or in standardising developmental tests. We highlight the deficiencies in using correlation coefficients or mean differences to assess agreement between these measures.