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Murdock AR, Rogers ML, Jackson TL, Monteiro K, Chambers LC. Mental Health Status of Rhode Island Middle School and High School Students Before Versus During the COVID-19 Pandemic. J Sch Health 2024; 94:489-500. [PMID: 38113526 PMCID: PMC11088986 DOI: 10.1111/josh.13424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/20/2023] [Accepted: 11/14/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND The COVID-19 pandemic negatively affected adolescent mental health due to school closures, isolation, family loss/hardships, and reduced health care access. METHODS We compared adolescent mental health in Rhode Island before versus during the pandemic, separately among middle and high schoolers. This serial cross-sectional study used Youth Risk Behavior Survey data from 2019 and 2021 (N = 7403). Multivariable logistic regression models estimated the association between year and mental health status, adjusting for sociodemographics. RESULTS Middle schoolers in 2021 had higher odds of ever seriously considering suicide (22.6% vs 16.7%) and ever attempting suicide (9.3% vs 6.1%) compared to 2019. Among high schoolers, those in 2021 had higher odds of experiencing persistent sadness/hopelessness in the past year (37.4% vs 32.0%). However, high schoolers in 2019 and 2021 had similar odds of considering suicide in the past year, while those in 2021 had lower odds of having attempted suicide in the past year (8.5% vs 14.6%). CONCLUSION The COVID-19 pandemic may have worsened multiple aspects of adolescent mental health in Rhode Island, particularly among middle schoolers. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Promoting school connectedness, creating supportive environments, and diversifying the mental health workforce may help overcome adverse pandemic effects.
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Affiliation(s)
- Abigail R. Murdock
- MPH Program, Brown University School of Public Health, 121 S Main St, Providence, RI 02912, United States
| | - Michelle L. Rogers
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 S Main St, Providence, RI 02912, United States
| | - Tracy L. Jackson
- Center for Health Data and Analysis, Rhode Island Department of Health, 3 Capitol Hill, Providence, RI 02912, United States
- Women & Infants Hospital of Rhode Island, 101 Dudley St, Providence, RI 02905, United States
| | - Karine Monteiro
- Center for Health Data and Analysis, Rhode Island Department of Health, 3 Capitol Hill, Providence, RI 02912, United States
| | - Laura C. Chambers
- Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI 02912, United States
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Fulton JP, Trikalinos TA, Popp J, Pollen S, Barclay D, Freeman M, Messick M. Estimating the Effectiveness of COVID-19 Mitigation Policy in Rhode Island. R I Med J (2013) 2024; 107:55-59. [PMID: 38687271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
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3
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Reddy AC, Gu JZ, Koo BH, Fruh V, Sax AJ. Urothelial Carcinoma: Epidemiology and Imaging-Based Review. R I Med J (2013) 2024; 107:26-32. [PMID: 38687266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Bladder cancer is the 6th most common malignancy in the United States, with urothelial carcinomas comprising over 95% of cases of bladder cancer, and commands a significant disease burden in Rhode Island. Imaging studies can provide valuable diagnostic information for urothelial carcinomas at initial presentation and are routinely used for noninvasive staging, treatment response monitoring, and post-treatment surveillance. This review aims to discuss and highlight three imaging modalities: ultrasonography, computed tomography, and magnetic resonance imaging, with particular focus on the notable features and appearance of urothelial carcinoma on each modality and their relative utility throughout the disease course. A general overview of disease epidemiology and treatment practices is also provided.
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Affiliation(s)
- Ashwin C Reddy
- The Warren Alpert Medical School of Brown University, Providence, RI
| | - Joey Z Gu
- Department of Medicine, Roger Williams Medical Center, Providence, RI
| | - Brandon H Koo
- Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Victoria Fruh
- Cancer Registry, Rhode Island Department of Health, Providence, RI
| | - Alessandra J Sax
- Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Providence, RI
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Lopez DS, Parent J, Stegnicki T, Kenyon Z, Arcoleo K, Malloy LC, Mello MJ. Overdosing in a Motor Vehicle: Examination of Human, Geographic, and Environmental Factors. Nurs Res 2024; 73:195-202. [PMID: 38329965 PMCID: PMC11039364 DOI: 10.1097/nnr.0000000000000716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
BACKGROUND Fentanyl, a type of opioid, in impaired driving cases increased across cities in the United States. OBJECTIVES No empirical studies have examined motor vehicle overdoses with fentanyl use. We investigated the magnitude of the motor vehicle overdose problem in Providence, RI, and the environmental, socioeconomic, and geographic conditions associated with motor vehicle overdose occurrence. METHODS This was a retrospective observational study of emergency medical services data on all suspected opioid overdoses between January 1, 2017, and October 31, 2020. The data contain forced-choice fields, such as age and biological sex, and an open-ended narrative in which the paramedic documented clinical and situational information. The overdoses were geocoded, allowing for the extraction of sociodemographic data from the U.S. Census Bureau's American Community Survey. Seven other data sources were included in a logistic regression to understand key risk factors and spatial patterns of motor vehicle overdoses. RESULTS Of the 1,357 opioid overdose cases in this analysis, 15.2% were defined as motor vehicle overdoses. In adjusted models, we found a 61% increase in the odds of a motor vehicle overdose involvement for men versus women, a 16.8% decrease in the odds of a motor vehicle overdose for a one-unit increase in distance to the nearest gas station, and a 10.7% decrease in the odds of a motor vehicle overdose for a one-unit increase in distance to a buprenorphine clinic. CONCLUSION There is a need to understand the interaction between drug use in vehicles to design interventions for decreasing driving after illicit drug use.
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Gibas KM, Auld D, Parente S, Horoho J, Mermel LA. Infections Associated with Medtronic Duet External Ventricular Drains - Rhode Island Hospital, Providence, Rhode Island, January 2023-January 2024. MMWR Morb Mortal Wkly Rep 2024; 73:312-316. [PMID: 38602895 PMCID: PMC11008792 DOI: 10.15585/mmwr.mm7314a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
External ventricular drains (EVDs) are medical devices that are inserted into the ventricles of the brain to drain excess fluid, manage intracranial hypertension, monitor intracranial pressure, and administer medications. Unintentional disconnections and breaks or fractures (breaks) of EVDs or associated drainage system components can result in cerebrospinal fluid (CSF) leakage and increased risk for EVD-associated infections. After replacement of Integra Life Sciences EVD systems with Medtronic Duet EVD systems at Rhode Island Hospital in mid-September 2023, a threefold increase was observed in the prevalence of positive CSF cultures, from 2.8 per 1,000 days with an EVD in place (EVD days) during January-September 2023 to 11.4 per 1,000 EVD days during October 2023-January 2024 (rate ratio [RR] = 5.7; 95% CI = 1.5-22.0; p = 0.01) and an eightfold increase in the prevalence of infections, from 0.7 to 6.5 per 1,000 EVD days (RR = 9.8; 95% CI = 1.1-87.3; p = 0.04). An investigation by Rhode Island Hospital Infection Control during December 2023-January 2024 identified frequent reports of disconnections and breaks of the Medtronic Duet EVD system. A search of the Food and Drug Administration Manufacturer and User Facility Device Experience database identified 326 reports nationwide of disconnection and breaks of components of the Duet EVD system, including 175 during 2023. A Medical Product Safety Network report was filed. The Duet EVD product was ultimately recalled in January 2024, citing disconnections of the EVD system and reports of CSF leakage and infection. Given the widespread use of EVD systems by neurosurgery centers and the risk for EVD-associated infections, a strategy for future consideration by hospital infection prevention and control programs might be inclusion of EVD-associated infections in hospital surveillance programs to rapidly identify increases in these events and determine factors related to such infections to prevent additional infections.
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Noel JK, Rosenthal SR, Torres JN, Gately KA, Borden SK. Driving after substance use in Rhode Island adolescents: A cross-sectional analysis of surveillance data. Traffic Inj Prev 2024; 25:562-570. [PMID: 38578273 DOI: 10.1080/15389588.2024.2335317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/22/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE Existing literature on driving under the influence during adolescence is sparse, especially for driving after the use of non-medical prescription drugs (DAP). This study examines the prevalence of driving after use of alcohol (DAA), cannabis (DAC), and DAP, and examines the role of several potential risk and protective factors. METHODS This was a secondary analysis of the 2022 Rhode Island Study Survey, a cross-sectional survey of middle and high school students. Separate multivariable regressions were conducted for each outcome among lifetime users for each substance, controlling for current substance use, individual-, perceived parental-, and perceived friend-substance use risk perception, age, sexual/gender minority (SGM) status, race, ethnicity, school level, and town poverty level. RESULTS Among lifetime users of alcohol (n = 3849), cannabis (n = 2289), and non-medical prescription drugs (n = 611), the prevalence of DAA, DAC, and DAP was 4.9, 14.3, and 16.9%, respectively. Current substance use, high individual risk perception, being nonwhite, and being Hispanic were risk factors for DAA while perceiving parent's risk perception as negative and being heterosexual cisgender-female were protective. Current substance use, negative individual risk perception, and being nonwhite were risk factors for DAC while perceiving parent's risk perception as negative and being in high school were protective. Current substance use and older age were risk factors for DAP while perceiving parent's risk perception as negative and perceiving friend's risk perception as negative were protective. CONCLUSIONS Driving under the influence is a concern among adolescent substance users. Current substance use and perceived parental risk perception as negative are common risks and protective factors, respectively. Findings suggest substance-specific, heterogeneous interventions are needed. For example, interventions focusing on peer perceptions are most relevant for DAP, while shifting personal perceptions of harm are most relevant for DAC.
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Affiliation(s)
- Jonathan K Noel
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, Rhode Island
- Center for Student Research & Interdisciplinary Collaboration, Johnson & Wales University, Providence, Rhode Island
| | - Samantha R Rosenthal
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, Rhode Island
- Center for Student Research & Interdisciplinary Collaboration, Johnson & Wales University, Providence, Rhode Island
- Department of Epidemiology, Brown School of Public Health, Providence, Rhode Island
| | - Jadyn N Torres
- Center for Student Research & Interdisciplinary Collaboration, Johnson & Wales University, Providence, Rhode Island
| | - Kelsey A Gately
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, Rhode Island
- Center for Student Research & Interdisciplinary Collaboration, Johnson & Wales University, Providence, Rhode Island
| | - Samantha K Borden
- Data Evaluation, and Compliance Unit, RI Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, Cranston, Rhode Island
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Batheja A, Balkrishnan R. Rhode Island as a model for promoting flu vaccination in the United States. Vaccine 2024; 42:1417-1419. [PMID: 38360474 DOI: 10.1016/j.vaccine.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/28/2024] [Accepted: 02/02/2024] [Indexed: 02/17/2024]
Affiliation(s)
| | - Rajesh Balkrishnan
- Department of Public Health Sciences and Cancer Center, University of Virginia, Charlottesville, USA.
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Drogosz M, Munthe S, Zwetchkenbaum S. Understanding the Relationship between Oral Health and Chronic Disease among Rhode Island Adults 45 years and Older. R I Med J (2013) 2024; 107:39-41. [PMID: 38412353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Affiliation(s)
- Monika Drogosz
- Oral Health Epidemiologist at the Rhode Island Department of Health
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Allen B, Schell RC, Jent VA, Krieger M, Pratty C, Hallowell BD, Goedel WC, Basta M, Yedinak JL, Li Y, Cartus AR, Marshall BDL, Cerdá M, Ahern J, Neill DB. PROVIDENT: Development and Validation of a Machine Learning Model to Predict Neighborhood-level Overdose Risk in Rhode Island. Epidemiology 2024; 35:232-240. [PMID: 38180881 PMCID: PMC10842082 DOI: 10.1097/ede.0000000000001695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
BACKGROUND Drug overdose persists as a leading cause of death in the United States, but resources to address it remain limited. As a result, health authorities must consider where to allocate scarce resources within their jurisdictions. Machine learning offers a strategy to identify areas with increased future overdose risk to proactively allocate overdose prevention resources. This modeling study is embedded in a randomized trial to measure the effect of proactive resource allocation on statewide overdose rates in Rhode Island (RI). METHODS We used statewide data from RI from 2016 to 2020 to develop an ensemble machine learning model predicting neighborhood-level fatal overdose risk. Our ensemble model integrated gradient boosting machine and super learner base models in a moving window framework to make predictions in 6-month intervals. Our performance target, developed a priori with the RI Department of Health, was to identify the 20% of RI neighborhoods containing at least 40% of statewide overdose deaths, including at least one neighborhood per municipality. The model was validated after trial launch. RESULTS Our model selected priority neighborhoods capturing 40.2% of statewide overdose deaths during the test periods and 44.1% of statewide overdose deaths during validation periods. Our ensemble outperformed the base models during the test periods and performed comparably to the best-performing base model during the validation periods. CONCLUSIONS We demonstrated the capacity for machine learning models to predict neighborhood-level fatal overdose risk to a degree of accuracy suitable for practitioners. Jurisdictions may consider predictive modeling as a tool to guide allocation of scarce resources.
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Affiliation(s)
- Bennett Allen
- From the Center for Opioid Epidemiology and Policy, Department of Population Health, Grossman School of Medicine, New York University, New York, NY, USA
| | - Robert C Schell
- Division of Health Policy and Management, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Victoria A Jent
- From the Center for Opioid Epidemiology and Policy, Department of Population Health, Grossman School of Medicine, New York University, New York, NY, USA
| | - Maxwell Krieger
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Claire Pratty
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Benjamin D Hallowell
- Center for Health Data and Analysis, Rhode Island Department of Health, Providence, RI, USA
| | - William C Goedel
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Melissa Basta
- Center for Health Data and Analysis, Rhode Island Department of Health, Providence, RI, USA
| | - Jesse L Yedinak
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Yu Li
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Abigail R Cartus
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Brandon D L Marshall
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Magdalena Cerdá
- From the Center for Opioid Epidemiology and Policy, Department of Population Health, Grossman School of Medicine, New York University, New York, NY, USA
| | - Jennifer Ahern
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Daniel B Neill
- Center for Urban Science and Progress, New York University, New York, NY, USA
- Department of Computer Science, Courant Institute for Mathematical Sciences, New York University, New York, NY, USA
- Robert F. Wagner Graduate School of Public Service, New York University, New York, NY, USA
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Samuels EA, Goedel WC, Jent V, Conkey L, Hallowell BD, Karim S, Koziol J, Becker S, Yorlets RR, Merchant R, Keeler LA, Reddy N, McDonald J, Alexander-Scott N, Cerda M, Marshall BDL. Characterizing opioid overdose hotspots for place-based overdose prevention and treatment interventions: A geo-spatial analysis of Rhode Island, USA. Int J Drug Policy 2024; 125:104322. [PMID: 38245914 DOI: 10.1016/j.drugpo.2024.104322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/10/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024]
Abstract
OBJECTIVE Examine differences in neighborhood characteristics and services between overdose hotspot and non-hotspot neighborhoods and identify neighborhood-level population factors associated with increased overdose incidence. METHODS We conducted a population-based retrospective analysis of Rhode Island, USA residents who had a fatal or non-fatal overdose from 2016 to 2020 using an environmental scan and data from Rhode Island emergency medical services, State Unintentional Drug Overdose Reporting System, and the American Community Survey. We conducted a spatial scan via SaTScan to identify non-fatal and fatal overdose hotspots and compared the characteristics of hotspot and non-hotspot neighborhoods. We identified associations between census block group-level characteristics using a Besag-York-Mollié model specification with a conditional autoregressive spatial random effect. RESULTS We identified 7 non-fatal and 3 fatal overdose hotspots in Rhode Island during the study period. Hotspot neighborhoods had higher proportions of Black and Latino/a residents, renter-occupied housing, vacant housing, unemployment, and cost-burdened households. A higher proportion of hotspot neighborhoods had a religious organization, a health center, or a police station. Non-fatal overdose risk increased in a dose responsive manner with increasing proportions of residents living in poverty. There was increased relative risk of non-fatal and fatal overdoses in neighborhoods with crowded housing above the mean (RR 1.19 [95 % CI 1.05, 1.34]; RR 1.21 [95 % CI 1.18, 1.38], respectively). CONCLUSION Neighborhoods with increased prevalence of housing instability and poverty are at highest risk of overdose. The high availability of social services in overdose hotspots presents an opportunity to work with established organizations to prevent overdose deaths.
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Affiliation(s)
- Elizabeth A Samuels
- Department of Emergency Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA; Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Drug Overdose Prevention Program, Rhode Island Department of Health, Providence, RI, USA.
| | - William C Goedel
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Victoria Jent
- Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, New York University, New York City, NY, USA
| | - Lauren Conkey
- Drug Overdose Prevention Program, Rhode Island Department of Health, Providence, RI, USA
| | - Benjamin D Hallowell
- Drug Overdose Prevention Program, Rhode Island Department of Health, Providence, RI, USA
| | - Sarah Karim
- Drug Overdose Prevention Program, Rhode Island Department of Health, Providence, RI, USA
| | - Jennifer Koziol
- Drug Overdose Prevention Program, Rhode Island Department of Health, Providence, RI, USA
| | - Sara Becker
- Center for Dissemination and Implementation Science, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Rachel R Yorlets
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Population Studies and Training Center, Brown University, Providence, RI, USA
| | - Roland Merchant
- Department of Emergency Medicine, Mount Sinai, New York City, NY, USA
| | - Lee Ann Keeler
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA
| | - Neha Reddy
- Department of Obstetrics and Gynecology, UChicago Medicine, Chicago, IL, USA
| | - James McDonald
- Drug Overdose Prevention Program, Rhode Island Department of Health, Providence, RI, USA
| | - Nicole Alexander-Scott
- Drug Overdose Prevention Program, Rhode Island Department of Health, Providence, RI, USA
| | - Magdalena Cerda
- Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, New York University, New York City, NY, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
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Vargas SE, Tao J, Almonte AA, Ramirez L, Chan PA. Increasing Incidence of Gonorrhea at an Urban STI Clinic in the United States. R I Med J (2013) 2024; 107:26-31. [PMID: 38412351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Medical record data was extracted from a sexually transmitted infection (STI) clinic in Providence, Rhode Island to characterize trends in Neisseria gonorrhoeae (GC) infection and explore risk factors. Of 16,601 clinical encounters, 6% (n=991) tested GC positive: 5.28 GC case rate (per 100 encounters) in the first two years of data collection (2015-2016) and 7.04 in the last two years (2020-2021). Analysis suggested a single linear trend line over time (p<.05). Overall, in more recent years, patients were older and more like to identify as male, Black, and Hispanic/Latino, as well as to have reported a previous STI, current symptoms, and specific risk behaviors. GC-positive patients in 2020-2021 were older and more like to identify as female and Black compared to 2015-2016. Lower rates of condom use were especially salient among female patients. These findings may reflect GC trends in the community.
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Affiliation(s)
- Sara E Vargas
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI
| | - Jun Tao
- Infectious Disease, The Miriam Hospital, Providence, RI, 02906; Department of Medicine, Alpert Medical School of Brown University, Providence, RI
| | | | - Leslie Ramirez
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
| | - Philip A Chan
- Infectious Disease, The Miriam Hospital, Providence, RI; Department of Medicine, Alpert Medical School of Brown University, Providence, RI
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Fulkerson H, Giampaolo G, Melia D, Donaldson AA. Weight Recovery in an Outpatient Medical Eating Disorders Clinic: A Retrospective Review. R I Med J (2013) 2024; 107:19-21. [PMID: 38412349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND The purpose of this study was to identify rates of weight recovery among adolescents and young adults with restrictive eating disorders (RED) as part of a quality improvement assessment in an Adolescent Medicine outpatient clinic in Rhode Island. METHODS A retrospective chart review was completed on 94 randomly selected patients ages 10-21 years old. Demographics, descriptors, time to weight recovery, and participation in other care were recorded. RESULTS The average age of participants was 15 years; most were female, cis-gender, White, had private insurance, and had one or more co-morbid psychiatric diagnosis. At intake, 81% were <95% treatment goal weight (TGW), with 27% at <80% TGW. Among participants who started at <95% of TGW, 51% achieved ≥95% of TGW; participants who engaged in a higher level of care were more successful. CONCLUSIONS This study identifies outcomes and highlights the challenge of weight recovery among patients with RED, even when managed by an expert clinical team.
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Affiliation(s)
- Hailey Fulkerson
- The Warren Alpert Medical School of Brown University, Providence, RI
| | | | | | - Abigail A Donaldson
- The Warren Alpert Medical School of Brown University, Providence, RI; Rhode Island Hospital/Hasbro Children's Hospital Department of Pediatrics, Division of Adolescent Medicine
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Vyas A, Kamat S, Oh J. Rhode Island (RI) Women's Breast Cancer Mammography Use Prior to and After Cancer Diagnosis: Linkage of RI Cancer Registry Data With RI All-Payer Claims Database. J Public Health Manag Pract 2024; 30:E65-E73. [PMID: 38271112 DOI: 10.1097/phh.0000000000001862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE A limitation of the central cancer registries to examine associations between mammography use and cancer diagnosis is their lack of cancer screening history. To fill this measurement gap, Rhode Island Cancer Registry (RICR) breast cancer (BC) records were linked to Rhode Island-all-payer claims database (RI-APCD) to study Rhode Island (RI) women's regular mammography use and identify its predictors. METHODS From the linked 2011-2019 data, we identified 4 study cohorts: (1) women who ever received mammography by Women's Cancer Screening Program (WCSP) and were diagnosed with BC ("WCSP-BC" cohort: n = 149), (2) women diagnosed with BC outside of WCSP (BC-control cohort: n = 4304), (3) women with a history of mammography use at WCSP but no BC diagnosis (n = 6513), and (4) general RI women with no BC diagnosis (n = 15 121). Logistic regressions were conducted to identify predictors of regular mammography use. RESULTS The linkage for RI-APCD and RICR for our study had a high matching rate of 82%. Mammography use prior to BC diagnosis was not different between the WCSP-BC cohort and the BC-control cohort (58% vs 57%). Women in the BC-control cohort who had mammography in 2 years prior to their cancer diagnosis were more likely of being diagnosed at an early-stage disease. Among BC-control group, women with no anxiety/depression or with no preventive examinations were less likely of regular mammography use. Among women with no BC, a lower proportion of women with a history of screening at WCSP had regular mammography use, compared with the general RI women (38% vs 66%). CONCLUSION RI-APCD data linkage with RICR provides excellent opportunities to examine regular mammography use among RI women and compare their outcomes to the general women population in the state. We identified opportunities for improving their mammography use. A measurement gap in the central cancer registries can be effectively reduced by utilizing statewide claims database.
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Affiliation(s)
- Ami Vyas
- Department of Pharmacy Practice & Clinical Research, The University of Rhode Island, College of Pharmacy, Kingston, Rhode Island (Dr Vyas and Ms Kamat); and Rhode Island Department of Health, Providence, Rhode Island (Ms Oh)
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Rodriguez M, McKenzie M, McKee H, Ledingham EM, John K, Koziol J, Hallowell BD. Differences in Substance Use and Harm Reduction Practices by Race and Ethnicity: Rhode Island Harm Reduction Surveillance System, 2021-2022. J Public Health Manag Pract 2024; 30:E84-E93. [PMID: 38153310 PMCID: PMC10872563 DOI: 10.1097/phh.0000000000001863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
CONTEXT In the United States, minority populations are disproportionately affected by the overdose epidemic, have higher mortality rates, and unequal access to harm reduction and treatment services. OBJECTIVE This analysis aims to better understand harm reduction utilization and substance use patterns among minority populations to improve overdose outreach and prevention initiatives in Rhode Island. DESIGN The present analysis used data from the Harm Reduction Surveillance System from January 2021 to December 2022 (N = 393). Chi-square tests and multivariable regression models were used to investigate differences in substance use behaviors by race and ethnicity. SETTING Rhode Island. PARTICIPANTS Participants include individuals who self-reported the use of illicit drugs, currently reside in Rhode Island, and were older than 18 years. MAIN OUTCOME MEASURES Methods of drug use and uptake of harm reduction practices. RESULTS Among survey participants, 41% were non-Hispanic White, 57% were aged 25 to 44 years, 62% identified as male, and 95% had health insurance coverage. Most participants reported smoking as their method of drug use (90%) and harm reduction practices were underutilized by all race and ethnicity groups. Fewer non-Hispanic Black participants reported carrying naloxone compared to the other race and ethnicity groups. Non-Hispanic Black and Hispanic participants were significantly less likely to inject drugs compared with non-Hispanic White participants (adjusted odds ratio [AOR] = 0.14; 95% confidence interval [CI], 0.04-0.45) (AOR = 0.40; 95% CI, 0.18-0.90). CONCLUSIONS Smoking was the most common self-reported method of substance administration for all participants, whereas injection was more prevalent among non-Hispanic White participants. There is a continued need for minority-led and culturally informed harm reduction and treatment services for minority populations.
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Affiliation(s)
- McClaren Rodriguez
- Substance Use Epidemiology Program, Center for Health Data Analysis, Rhode Island Department of Health, Providence, Rhode Island (Mss Rodriguez, Ledingham, and St. John and Dr Hallowell); Preventing Overdose and Naloxone Intervention (PONI), The Miriam Hospital, Providence, Rhode Island (Mss McKenzie and McKee); and Drug Overdose Prevention Program, Center for Health Data Analysis, Rhode Island Department of Health, Providence, Rhode Island (Ms Koziol)
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15
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Tan M, Park C, Goldman J, Biello KB, Buxton J, Hadland SE, Park JN, Sherman SG, Macmadu A, Marshall BDL. Association between willingness to use an overdose prevention center and probation or parole status among people who use drugs in Rhode Island. Harm Reduct J 2024; 21:54. [PMID: 38424553 PMCID: PMC10905878 DOI: 10.1186/s12954-024-00969-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Overdose prevention centers (OPCs) are being implemented in the United States as a strategy to reduce drug-related mortality and morbidity. Previous studies have suggested that people who use drugs (PWUD) with a history of criminal legal system (CLS) involvement (e.g. current probation/parole) are at greater risk of overdose but may also encounter significant barriers to OPC use. The objective of this study was to explore the association between willingness to use an OPC and probation/parole status in a sample of PWUD in Rhode Island. METHODS This study utilized data from the Rhode Island Prescription and Illicit Drug Study, which enrolled adult PWUD from August 2020 to February 2023. We used Pearson's chi-square and Wilcoxon rank-sum tests to assess bivariate associations between willingness to use an OPC and probation/parole status (current/previous/never), as well as other sociodemographic and behavioral characteristics. In multivariable Poisson analyses, we examined the association between willingness to use an OPC and probation/parole status, adjusting for key sociodemographic and behavioral characteristics. RESULTS Among 482 study participants, 67% were male, 56% identified as white, 20% identified as Hispanic/Latine, and the median age was 43 (IQR 35-53). Nearly a quarter (24%) had never been on probation/parole, 44% were not currently on probation/parole but had a lifetime history of probation and parole, and 32% were currently on probation/parole. Most participants (71%) reported willingness to use an OPC, and in both bivariate and multivariable analyses, willingness to use an OPC did not vary by probation/parole status. Crack cocaine use and lifetime non-fatal overdose were associated with greater willingness to use an OPC (all p < 0.05). CONCLUSIONS These data demonstrate high willingness to use OPC among PWUD in Rhode Island regardless of CLS-involvement. As OPCs begin to be implemented in Rhode Island, it will be imperative to engage people with CLS-involvement and to ensure access to the OPC and protection against re-incarceration due to potential barriers, such as police surveillance of OPCs.
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Affiliation(s)
- Michael Tan
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Carolyn Park
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Jacqueline Goldman
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Katie B Biello
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Jane Buxton
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Scott E Hadland
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ju Nyeong Park
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Susan G Sherman
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alexandria Macmadu
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.
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16
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Yedinak J, Krieger MS, Joseph R, Levin S, Edwards S, Bailer DA, Goyer J, Daley Ndoye C, Schultz C, Koziol J, Elmaleh R, Hallowell BD, Hampson T, Duong E, Shihipar A, Goedel WC, Marshall BD. Public Health Dashboards in Overdose Prevention: The Rhode Island Approach to Public Health Data Literacy, Partnerships, and Action. J Med Internet Res 2024; 26:e51671. [PMID: 38345849 PMCID: PMC10897802 DOI: 10.2196/51671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/12/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024] Open
Abstract
As the field of public health rises to the demands of real-time surveillance and rapid data-sharing needs in a postpandemic world, it is time to examine our approaches to the dissemination and accessibility of such data. Distinct challenges exist when working to develop a shared public health language and narratives based on data. It requires that we assess our understanding of public health data literacy, revisit our approach to communication and engagement, and continuously evaluate our impact and relevance. Key stakeholders and cocreators are critical to this process and include people with lived experience, community organizations, governmental partners, and research institutions. In this viewpoint paper, we offer an instructive approach to the tools we used, assessed, and adapted across 3 unique overdose data dashboard projects in Rhode Island, United States. We are calling this model the "Rhode Island Approach to Public Health Data Literacy, Partnerships, and Action." This approach reflects the iterative lessons learned about the improvement of data dashboards through collaboration and strong partnerships across community members, state agencies, and an academic research team. We will highlight key tools and approaches that are accessible and engaging and allow developers and stakeholders to self-assess their goals for their data dashboards and evaluate engagement with these tools by their desired audiences and users.
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Affiliation(s)
- Jesse Yedinak
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - Maxwell S Krieger
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | | | - Stacey Levin
- Parent Support Network, Warwick, RI, United States
| | - Sarah Edwards
- Rhode Island Department of Health, Providence, RI, United States
| | | | | | | | - Cathy Schultz
- State of Rhode Island Executive Office of Health and Human Services, Cranston, RI, United States
| | - Jennifer Koziol
- Rhode Island Department of Health, Providence, RI, United States
| | - Rachael Elmaleh
- Rhode Island Department of Health, Providence, RI, United States
| | | | - Todd Hampson
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - Ellen Duong
- Center for Computation and Visualization, Brown University, Providence, RI, United States
| | - Abdullah Shihipar
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - William C Goedel
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - Brandon Dl Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
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17
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Ogwara CA, Ronberg JW, Cox SM, Wagner BM, Stotts JW, Chowell G, Spaulding AC, Fung ICH. Impact of public health policy and mobility change on transmission potential of severe acute respiratory syndrome coronavirus 2 in Rhode Island, March 2020 - November 2021. Pathog Glob Health 2024; 118:65-79. [PMID: 37075167 PMCID: PMC10769146 DOI: 10.1080/20477724.2023.2201984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
To study the SARS-CoV-2 transmission potential in Rhode Island (RI) and its association with policy changes and mobility changes, the time-varying reproduction number, Rt, was estimated. The daily incident case counts (16 March 2020, through 30 November 2021) were bootstrapped within a 15-day sliding window and multiplied by Poisson-distributed multipliers (λ = 4, sensitivity analysis: 11) to generate 1000 estimated infection counts, to which EpiEstim was applied to generate Rt time series. The median Rt percentage change when policies changed was estimated. The time lag correlations were assessed between the 7-day moving average of the relative changes in Google mobility data in the first 90 days, and Rt and estimated infection count, respectively. There were three major pandemic waves in RI in 2020-2021: spring 2020, winter 2020-2021 and fall-winter 2021. The median Rt fluctuated within the range of 0.5-2 from April 2020 to November 2021. Mask mandate (18 April 2020) was associated with a decrease in Rt (-25.99%, 95% CrI: -37.42%, -14.30%). Termination of mask mandates on 6 July 2021 was associated with an increase in Rt (36.74%, 95% CrI: 27.20%, 49.13%). Positive correlations were found between changes in grocery and pharmacy, Rt retail and recreation, transit, and workplace visits, for both Rt and estimated infection count, respectively. Negative correlations were found between changes in residential area visits for both Rt and estimated infection count, respectively. Public health policies enacted in RI were associated with changes in the pandemic trajectory. This ecological study provides further evidence of how non-pharmaceutical interventions and vaccination slowed COVID-19 transmission in RI.
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Affiliation(s)
- Chigozie A. Ogwara
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Jennifer W. Ronberg
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Sierra M. Cox
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Briana M. Wagner
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Jacqueline W. Stotts
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Gerardo Chowell
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Anne C. Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Isaac Chun-Hai Fung
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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18
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Paiva TJ, Katz M, Arias W, St John K. Prescription Drug Exposure Among Pregnant Individuals in Rhode Island, 2019-2022. R I Med J (2013) 2024; 107:50-53. [PMID: 38285755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Affiliation(s)
- Taylor J Paiva
- Prescription Drug Monitoring Program Epidemiologist, Center for Health Data and Analysis (CHDA), RIDOH
| | - Margo Katz
- Substance Exposed Newborn Program Manager, Division of Community Health and Equity, RIDOH
| | - William Arias
- Maternal and Child Health Epidemiologist, Center for Health Data and Analysis (CHDA), RIDOH
| | - Kristen St John
- Substance Use Epidemiologist, Center for Health Data and Analysis (CHDA), RIDOH
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19
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Bloom M, Gjelsvik A, Amanullah S. Stress During Pregnancy Associated with Newborn Low Birth Weight: Experiences from the State of Rhode Island. Matern Child Health J 2024; 28:344-350. [PMID: 37955837 DOI: 10.1007/s10995-023-03845-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE Prenatal stress is a known risk for poor birth outcomes. This study specifically looked at reported stress during pregnancy and low birth weight (LBW) in Rhode Island. METHODS Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2016 to 2018 for the state of Rhode Island was utilized. Stress during most recent pregnancy was dichotomized as: 'none to minimal' and 'moderate to high.' LBW was defined as less than 2,500 g. Multivariable regression analysis was performed, accounting for complex survey design. RESULTS In this cohort, 24% of pregnant people reported moderate to high stress leading to an adjusted odds of 1.70 (95% CI 1.43-2.03) of having a LBW newborn compared to those with none to minimal stress. Primiparity, previous preterm birth, racism, smoking history, and history of chronic medical problems were also associated with LBW newborns. CONCLUSION We recommend screening and provision of support services for stress in all settings where pregnant people access care.
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Affiliation(s)
- Molly Bloom
- Global Health/Faculty Development Fellow in the department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Annie Gjelsvik
- Department of Epidemiology, Director of MPH Program, Brown University School of Public Health, Providence, RI, USA
| | - Siraj Amanullah
- Department of Emergency Medicine, Pediatrics, and Health Services, Policy and Practice, Alpert Medical School of Brown University and Brown School of Public Health, Hasbro Children's Hospital/Rhode Island, Hospital/Providence Rhode Island, Providence, RI, USA
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20
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Flowers D, Goodspeed E, Daly M. Telehealth as an Effective Care Delivery Method During the COVID-19 Pandemic for the Rhode Island Behavioral Health Population. Community Ment Health J 2024; 60:108-114. [PMID: 37737526 DOI: 10.1007/s10597-023-01187-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
In response to the COVID-19 pandemic, Rhode Island implemented a telehealth waiver allowing telehealth parity. This study investigated (1) if telehealth allowed for patients who seek mental health services to maintain visit frequency and (2) if subpopulations were less likely to utilize telehealth. We used descriptive statistics to analyze the change in total number of visits, in-person visits from pre-waiver to post-waiver, and a multivariate linear regression to identify relationships between demographics and telehealth utilization. Participants were able to maintain the frequency of visits during the COVID-19 pandemic. Race/ethnicity, age, gender, employment status, and housing status were all statistically significant predictors of telehealth utilization. Telehealth aids in the continuing of care when in-person visits are not a viable option. Access to telehealth is crucial during public health emergencies and aids in maintaining visit frequency. Further research should be done to evaluate subgroups who are less likely to utilize telehealth.
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Affiliation(s)
- Demetria Flowers
- Department of Behavioral Health, Developmental Disabilities and Hospitals, State of Rhode Island, Cranston, RI, 02904, USA.
| | - Emily Goodspeed
- Department of Behavioral Health, Developmental Disabilities and Hospitals, State of Rhode Island, Cranston, RI, 02904, USA
| | - Mackenzie Daly
- Department of Behavioral Health, Developmental Disabilities and Hospitals, State of Rhode Island, Cranston, RI, 02904, USA
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21
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Duan K, Chambers LC, Basta M, Scagos RP, Roberts-Santana C, Hallowell BD. Prior Emergency Medical Services Utilization Among People Who Had an Accidental Opioid-Involved Fatal Drug Overdose-Rhode Island, 2018-2020. Public Health Rep 2024; 139:48-53. [PMID: 36891978 PMCID: PMC10905757 DOI: 10.1177/00333549231154582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
OBJECTIVE To help understand whether decreased emergency medical services (EMS) utilization due to the COVID-19 pandemic contributed to increased accidental fatal drug overdoses, we characterized recent EMS utilization history among people who had an accidental opioid-involved fatal drug overdose in Rhode Island. METHODS We identified accidental opioid-involved fatal drug overdoses among Rhode Island residents that occurred from January 1, 2018, through December 31, 2020. We linked decedents by name and date of birth to the Rhode Island EMS Information System to obtain EMS utilization history. RESULTS Among 763 people who had an accidental opioid-involved fatal overdose, 51% had any EMS run and 16% had any opioid overdose-related EMS run in the 2 years before death. Non-Hispanic White decedents were significantly more likely than decedents of other races and ethnicities to have any EMS run (P < .001) and any opioid overdose-related EMS run (P = .05) in the 2 years before death. Despite a 31% increase in fatal overdoses from 2019 through 2020, corresponding with the onset of the COVID-19 pandemic, EMS utilization in the prior 2 years, prior 180 days, or prior 90 days did not vary by time frame of death. CONCLUSION In Rhode Island, decreased EMS utilization because of the COVID-19 pandemic was not a driving force behind the increase in overdose fatalities observed in 2020. However, with half of people who had an accidental opioid-involved fatal drug overdose having an EMS run in the 2 years before death, emergency care is a potential opportunity to link people to health care and social services.
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Affiliation(s)
- Kailai Duan
- Rhode Island Department of Health, Providence, RI, USA
| | - Laura C. Chambers
- Rhode Island Department of Health, Providence, RI, USA
- The Miriam Hospital, Providence, RI, USA
| | - Melissa Basta
- Rhode Island Department of Health, Providence, RI, USA
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22
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Collins AB, Kaplowitz E, Bastani P, McKee H, Whitaker D, Hallowell BD, McKenzie M. "I Don't Go Overboard": Perceptions of Overdose Risk and Risk Reduction Strategies among People Who Use Drugs in Rhode Island. Subst Use Misuse 2023; 59:673-679. [PMID: 38124349 PMCID: PMC10922331 DOI: 10.1080/10826084.2023.2294968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Background: North America experiencing an unprecedented overdose epidemic, with data estimating almost 110,000 overdose deaths occurring in 2022 in the United States (US). To address fatal overdoses in the US, community organizations and local health departments in some jurisdictions have expanded community distribution of naloxone, and increased overdose prevention education, and other harm reduction supplies and services (e.g., fentanyl test strips, drug checking programs) to reduce harm for people who use drugs (PWUD). Objectives: Understanding how PWUD manage overdose risk within the context of these expanded services is important for ensuring public health services are meeting their needs. Semi-structured qualitative interviews were conducted with 25 PWUD who were accessing harm reduction services in Rhode Island. Data were imported into NVivo where they were coded and analyzed thematically. Results: Our findings demonstrate the complexity of managing overdose risk in the context of a fentanyl drug supply. While most participants were concerned about overdosing, they sought to manage overdose risk through their own harm reduction practices (e.g., testing their drugs, going slow) and drug purchasing dynamics, even when using alone. Conclusions: Study findings point to the need to implement and scale-up community-level interventions to better support PWUD within the context of the current US overdose crisis.
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Affiliation(s)
- Alexandra B Collins
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Eliana Kaplowitz
- Center for Health and Justice Transformation, Providence, Rhode Island, USA
| | - Parsa Bastani
- Department of Anthropology, Brown University, Providence, Rhode Island, USA
| | - Haley McKee
- The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Delaney Whitaker
- Center for Health and Justice Transformation, Providence, Rhode Island, USA
| | - Benjamin D Hallowell
- Center For Health Data and Analysis, Rhode Island Department of Health, Providence, Rhode Island, USA
| | - Michelle McKenzie
- The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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23
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Bhattarai L, MacAskill M, Brown E, Bertrand T, Chan PA, Bornschein S. Epidemiological Patterns of HIV Diagnoses Among Women in Rhode Island: An Overview. R I Med J (2013) 2023; 106:62-64. [PMID: 38015789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Affiliation(s)
- Lila Bhattarai
- HIV Surveillance Manager, Center for HIV, Hepatitis, STD and TB, Rhode Island Department of Health
| | - Meghan MacAskill
- HIV Epidemiologist, Center for HIV, Hepatitis, STD and TB, Rhode Island Department of Health
| | - Erin Brown
- Program Evaluator, Center for HIV, Hepatitis, STD and TB, Rhode Island Department of Health
| | - Thomas Bertrand
- Chief, Center for HIV, Hepatitis, STD and TB, Rhode Island Department of Health
| | - Philip A Chan
- Consultant Medical Director, Center for HIV, Hepatitis, STD and TB, Rhode Island Department of Health
| | - Suzanne Bornschein
- Medical Director, Center for HIV, Hepatitis, STD, and TB, Rhode Island Department of Health
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Zhang H, George-Washburn EA, Lin EM, Baranwal N, Lim RK, Caravaglio J, Qureshi A, Cho E. Associations between season, climate, and pediatric alopecia areata flares in Providence, Rhode Island. Arch Dermatol Res 2023; 315:2877-2881. [PMID: 37682336 DOI: 10.1007/s00403-023-02721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/03/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023]
Abstract
Patients with alopecia areata (AA) may experience episodic hair loss that follows seasonal patterns. To assess associations between seasonal variation, climate factors, and AA flare frequency in pediatric AA patients, we performed a retrospective chart review of 123 pediatric AA patients at Brown Dermatology (Providence, Rhode Island) who experienced hair loss between January 2017 and December 2019. We assessed association of seasonal variation with monthly occurrence of AA flares. We then assessed association between climate variables and monthly AA hair loss frequency using Spearman rank correlation analyses. We conducted stratified analyses in patients with and without history of atopy. The greatest proportion of hair loss episodes occurred in winter (28.1%), followed by autumn (26.3%), spring (23.8%), and summer (21.7%). We found significant correlations between AA hair loss frequency and air pressure (R = 0.61) and hours of sunlight (R = - 0.60). These correlations remained significant among patients with no history of atopic disease but were not significant among those with history of atopy. Limitations include small sample size. This regional analysis supports the role of climate in AA hair loss episodes through assessment of seasonal occurrences and identification of correlations between climate characteristics and AA flare frequency.
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Affiliation(s)
- Helen Zhang
- Warren Alpert Medical School of Brown University, 339 Eddy Street, Providence, RI, 02903, USA
| | | | - Erica M Lin
- Warren Alpert Medical School of Brown University, 339 Eddy Street, Providence, RI, 02903, USA
| | - Navya Baranwal
- Warren Alpert Medical School of Brown University, 339 Eddy Street, Providence, RI, 02903, USA
| | - Rachel K Lim
- Warren Alpert Medical School of Brown University, 339 Eddy Street, Providence, RI, 02903, USA
| | - Joseph Caravaglio
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Abrar Qureshi
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, RI, USA.
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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25
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Slingsby BA, Schroeder C, Stock-Guil K, Keogh A. Medical Evaluations in Rhode Island for Suspected Child Abuse and Neglect Prior to and During the COVID-19 Pandemic. R I Med J (2013) 2023; 106:15-19. [PMID: 37890058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
During the COVID-19 pandemic, there was an increase in several risk factors for child maltreatment. There was also a sudden decrease in the systems available to identify and support at risk children and families. This study aims to describe the number of children presenting to specialized medical care for suspected child abuse and neglect during the first seven months of the COVID-19 pandemic compared to the three previous years. This was a retrospective chart review of all cases evaluated by the child abuse team in Rhode Island from March 1st until September 30th of 2017, 2018, 2019 and 2020. During the first seven months of the COVID-19 pandemic, there were 10% fewer children evaluated by the child abuse team with the most significant decrease (35%) in the number of children evaluated for physical abuse. With the known increased risk factors for physical abuse due to COVID-19, the decrease in the number of children evaluated for physical abuse is unlikely due to a decrease in the incidence of physical abuse. This decrease is most likely due to physical abuse not being identified or children not being referred to specialized medical care. Without the ability to see and interact with children in person, professionals' ability to identify child victims of abuse is limited. Professionals working with children and families at risk should develop strategies to be able to continue to provide in-person services in the future if another pandemic or natural disaster occurs.
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Affiliation(s)
- Brett A Slingsby
- Warren Alpert Medical School of Brown University; Rhode Island Hospital/Hasbro Children's Hospital, Providence, Rhode Island
| | | | - Kara Stock-Guil
- Rhode Island Hospital/Hasbro Children's Hospital, Providence Rhode Island
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Ledingham EM, St John K, Hallowell BD. Deaths Involving Fully Alcohol-Attributable Chronic Conditions in Rhode Island: 2018-2022. R I Med J (2013) 2023; 106:60-63. [PMID: 37890068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Affiliation(s)
- Emily M Ledingham
- Alcohol Epidemiologist, Center for Health Data and Analysis (CHDA), Rhode Island Department of Health (RIDOH)
| | - Kristen St John
- Substance Use Epidemiologist, Center for Health Data and Analysis (CHDA), Rhode Island Department of Health (RIDOH)
| | - Benjamin D Hallowell
- Substance Use Epidemiology Program Team Lead, Center for Health Data and Analysis (CHDA), Rhode Island Department of Health (RIDOH)
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Omari J, Weidele HR, Tavares MB, Rodriguez M, Hallowell BD. Racial and Ethnic Disparities in Accidental and Undetermined Drug Overdose Deaths - Rhode Island, 2016-2021. R I Med J (2013) 2023; 106:55-59. [PMID: 37890067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
BACKGROUND Over the last 21 years, drug overdose deaths have increased nationwide, particularly in Rhode Island (RI). The goal of this work is to identify populations that are disproportionately impacted by accidental drug overdose deaths to guide future intervention efforts. Methods: We obtained data on accidental and undetermined drug overdose deaths from the RI State Unintentional Drug Overdose Reporting System (SUDORS) database from 2016 to 2021. We compared basic demographic factors stratified by decedent race and ethnicity. Chi Square and Fisher's exact tests were used to determine differences in characteristics across racial groups. FINDINGS Across all race and ethnic groups, cocaine-involved (64.5%) fatal overdoses were higher among Black non-Hispanics. White, non-Hispanics (31.4%) were more likely to receive treatment for substance use disorder (SUD) when compared to minority groups. CONCLUSION To help address the gaps in treatment for SUD among minority groups, culturally responsive intervention efforts should prioritize connecting minority groups to treatment.
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Affiliation(s)
- Justina Omari
- Senior Fatal Overdose Epidemiologist, Center for Health Data and Analysis (CHDA), RIDOH
| | - Heidi R Weidele
- Lead Fatal Overdose Epidemiologist, Center for Health Data and Analysis (CHDA), RIDOH
| | - Monica B Tavares
- Education and Outreach Coordinator, Center for Health Promotion, RIDOH
| | - McClaren Rodriguez
- Substance Use Epidemiologist, Center for Health Data and Analysis (CHDA), RIDOH
| | - Benjamin D Hallowell
- Substance Use Epidemiology Program Manager, Center for Health Data and Analysis (CHDA), RIDOH
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Allen B, Neill DB, Schell RC, Ahern J, Hallowell BD, Krieger M, Jent VA, Goedel WC, Cartus AR, Yedinak JL, Pratty C, Marshall BDL, Cerdá M. Translating Predictive Analytics for Public Health Practice: A Case Study of Overdose Prevention in Rhode Island. Am J Epidemiol 2023; 192:1659-1668. [PMID: 37204178 PMCID: PMC10558193 DOI: 10.1093/aje/kwad119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 03/09/2023] [Accepted: 05/15/2023] [Indexed: 05/20/2023] Open
Abstract
Prior applications of machine learning to population health have relied on conventional model assessment criteria, limiting the utility of models as decision support tools for public health practitioners. To facilitate practitioners' use of machine learning as a decision support tool for area-level intervention, we developed and applied 4 practice-based predictive model evaluation criteria (implementation capacity, preventive potential, health equity, and jurisdictional practicalities). We used a case study of overdose prevention in Rhode Island to illustrate how these criteria could inform public health practice and health equity promotion. We used Rhode Island overdose mortality records from January 2016-June 2020 (n = 1,408) and neighborhood-level US Census data. We employed 2 disparate machine learning models, Gaussian process and random forest, to illustrate the comparative utility of our criteria to guide interventions. Our models predicted 7.5%-36.4% of overdose deaths during the test period, illustrating the preventive potential of overdose interventions assuming 5%-20% statewide implementation capacities for neighborhood-level resource deployment. We describe the health equity implications of use of predictive modeling to guide interventions along the lines of urbanicity, racial/ethnic composition, and poverty. We then discuss considerations to complement predictive model evaluation criteria and inform the prevention and mitigation of spatially dynamic public health problems across the breadth of practice. This article is part of a Special Collection on Mental Health.
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Affiliation(s)
- Bennett Allen
- Correspondence to Dr. Bennett Allen, Center for Opioid Epidemiology and Policy, Grossman School of Medicine, New York University, 180 Madison Avenue, 4th Floor, Room 4-15, New York, NY 10016 (e-mail: )
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Moseley I, Ahmed F, Lin E, Lim R, Hoang M, Baranwal N, Robinson-Bostom L, Libby T, Wisco O, Qureshi A, Cho E. Host and primary tumor factors for the development of multiple cutaneous squamous cell carcinomas among a retrospective cohort in Rhode Island. J Am Acad Dermatol 2023; 89:511-518. [PMID: 37011813 DOI: 10.1016/j.jaad.2023.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 02/16/2023] [Accepted: 03/06/2023] [Indexed: 04/03/2023]
Abstract
INTRODUCTION Risk factors for a primary cutaneous squamous cell carcinoma (CSCC) are well-established; however, the host and primary tumor risk factors for subsequent CSCC have not been fully explored. METHODS We performed a retrospective chart review of patients diagnosed with CSCC in an academic dermatology clinic in Rhode Island from 2016-2019. Logistic regression was used to evaluate the associations between host factors and multiple CSCC and between primary tumor characteristics and the risk of subsequent CSCC. Adjusted odds ratios (aORs) and 95% CIs were calculated. RESULTS A total of 1312 patients with CSCC diagnoses were included. Host risk factors significantly associated with multiple CSCCs included: aged >80 years (aOR, 2.18; 95% CI, 1.46-3.31); history of: solid organ transplant (aOR, 2.41; 95% CI, 1.20-4.80); skin cancer (aOR, 1.96; 95% CI, 1.52-2.54); other cancer (aOR, 1.49; 95% CI, 1.11-2.00); family history of skin cancer (aOR, 1.36; 95% CI, 1.03-1.78); and actinic keratosis (aOR, 1.52; 95% CI, 1.18-1.95). Tumor location, diameter, histologic differentiation, and treatment were not significant predictors of subsequent CSCCs. LIMITATIONS Study patients were predominantly White and from a single institution, limiting the generalizability of results. CONCLUSIONS Certain host characteristics were associated with the development of subsequent CSCC, which may inform clinical guidelines for follow-up.
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Affiliation(s)
- Isabelle Moseley
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Fadwa Ahmed
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Erica Lin
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Rachel Lim
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Megan Hoang
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Navya Baranwal
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Leslie Robinson-Bostom
- Department of Dermatology, the Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Tiffany Libby
- Department of Dermatology, the Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Oliver Wisco
- Department of Dermatology, the Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Abrar Qureshi
- Department of Dermatology, the Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - Eunyoung Cho
- Department of Dermatology, the Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
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Chan PA, Nunn AS, Maynard M. Improving Access to HIV Prevention to End the Epidemic in Rhode Island. R I Med J (2013) 2023; 106:47-49. [PMID: 37643343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Affiliation(s)
- Philip A Chan
- Brown University; Open Door Health, Rhode Island Public Health Institute; Rhode Island Department of Health, Providence, RI
| | - Amy S Nunn
- Open Door Health, Rhode Island Public Health Institute; Rhode Island Department of Health, Providence, RI
| | - Michaela Maynard
- Open Door Health, Rhode Island Public Health Institute; Rhode Island Department of Health, Providence, RI
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Barré L, Phengsavatdy A, McDonald JV. Review of Complaints to the Rhode Island Board of Medical Licensure and Discipline 2018-2020. R I Med J (2013) 2023; 106:31-35. [PMID: 37643340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVE This study aimed to examine the patterns of complaints filed against physicians in Rhode Island, investigate the factors associated with complaint rates and outcomes, and assess the impact of the implementation of a new Framework for Just Culture. METHODS Complaint data from the Rhode Island Department of Health's complaint tracker and physician licensing database were analyzed for the period of 2018 to 2020. Descriptive and statistical process control analyses were conducted to assess complaint rates, investigation rates, and adverse outcomes. RESULTS Over the three-year period, 1672 complaints were filed against Rhode Island physicians, with approximately 40% of complaints being opened for investigation. The implementation of the Framework for Just Culture coincided with a sustained decrease in the rate of complaints opened. Failure to meet the minimum standard of care was the most common allegation, and male physicians and those aged 40-50 were more likely to have complaints filed against them. CONCLUSIONS The study highlights the importance of complaint investigations in upholding standards for medical licensure and clinical competence. The Framework for Just Culture may have influenced the investigation process, resulting in fewer investigations opened without compromising the identification of cases requiring disciplinary action. These findings provide insights into physician accountability and the need for ongoing monitoring and improvement in complaint handling systems.
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Affiliation(s)
- Luke Barré
- Hawthorn Medical Associates, Assistant Professor of Clinical Medicine, Boston University School of Medicine; Adjunct Assistant Professor in Medical Science, Alpert Medical School of Brown University
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Weidele HR, Omari J, Rodriguez M, Hallowell BD. Accidental Drug Overdose Deaths in Rhode Island: January 1, 2016-December 31, 2022. R I Med J (2013) 2023; 106:42-44. [PMID: 37643342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Affiliation(s)
- Heidi R Weidele
- Fatal Overdose Epidemiologist, Substance Use Epidemiology Program (SUEP) at RIDOH
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Chiumento G, Osinski A, DeVoe K, Houghton A, Joshi A, Ivanof C, Creegan E, Gosciminski M, Newman AP, Madison-Antenucci S, Hlavsa MC, Imada E, Lysen C, Miko S, Schultz J, Harvey E, Vostok J, Brown CM. Notes from the Field: Outbreak of Cryptosporidiosis Among Collegiate Swimmers and Evidence of Secondary Transmission - Massachusetts and Rhode Island, 2023. MMWR Morb Mortal Wkly Rep 2023; 72:734-735. [PMID: 37384560 PMCID: PMC10328492 DOI: 10.15585/mmwr.mm7226a7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
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Rosenthal SR, Tobin AP, Drammeh A, Swanberg JE, Noel JK. The Mental Health Burden of Racial Discrimination in Young Adults in Rhode Island. R I Med J (2013) 2023; 106:23-28. [PMID: 36989094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
OBJECTIVES This study examined the association between racial discrimination and depressive symptoms among Rhode Island young adults. METHODS The 2022 Rhode Island Young Adult Survey recruited 1,022 young adults aged 18-25 years who lived in Rhode Island for at least part of the year. Multivariable logistic regression for depressive symptoms controlled for sexual and gender identity, race/ethnicity, social status, age, employment, and student status. RESULTS 23.6% of young adults reported experiencing racial discrimination in childhood and/or adulthood. Odds of depressive symptoms increased for experiences of childhood racial discrimination (+70%; 95%CI: 14%, 155%) and any racial discrimination (+56%; 95%CI: 6%, 130%), but not for racial discrimination in adulthood (+38%; 95%CI: -8%, 108%). CONCLUSIONS Experiences of racial discrimination increase odds of depressive symptoms among young adults. Prevention measures such as universal screening for childhood adversity, incorporating antiracism education into all institutional settings, and continued nondiscrimination policy and enforcement should be employed.
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Affiliation(s)
- Samantha R Rosenthal
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, RI; Department of Epidemiology, Brown School of Public Health, Providence, RI
| | - Abigail P Tobin
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, RI
| | - Aisha Drammeh
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, RI
| | - Jennifer E Swanberg
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, RI
| | - Jonathan K Noel
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, RI
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Novitsky V, Steingrimsson J, Howison M, Dunn CW, Gillani FS, Fulton J, Bertrand T, Howe K, Bhattarai L, Ronquillo G, MacAskill M, Bandy U, Hogan J, Kantor R. Not all clusters are equal: dynamics of molecular HIV-1 clusters in a statewide Rhode Island epidemic. AIDS 2023; 37:389-399. [PMID: 36695355 PMCID: PMC9881752 DOI: 10.1097/qad.0000000000003426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Molecular epidemiology is a powerful tool to characterize HIV epidemics and prioritize public health interventions. Typically, HIV clusters are assumed to have uniform patterns over time. We hypothesized that assessment of cluster evolution would reveal distinct cluster behavior, possibly improving molecular epidemic characterization, towards disrupting HIV transmission. DESIGN Retrospective cohort. METHODS Annual phylogenies were inferred by cumulative aggregation of all available HIV-1 pol sequences of individuals with HIV-1 in Rhode Island (RI) between 1990 and 2020, representing a statewide epidemic. Molecular clusters were detected in annual phylogenies by strict and relaxed cluster definition criteria, and the impact of annual newly-diagnosed HIV-1 cases to the structure of individual clusters was examined over time. RESULTS Of 2153 individuals, 31% (strict criteria) - 47% (relaxed criteria) clustered. Longitudinal tracking of individual clusters identified three cluster types: normal, semi-normal and abnormal. Normal clusters (83-87% of all identified clusters) showed predicted growing/plateauing dynamics, with approximately three-fold higher growth rates in large (15-18%) vs. small (∼5%) clusters. Semi-normal clusters (1-2% of all clusters) temporarily fluctuated in size and composition. Abnormal clusters (11-16% of all clusters) demonstrated collapses and re-arrangements over time. Borderline values of cluster-defining parameters explained dynamics of non-normal clusters. CONCLUSIONS Comprehensive tracing of molecular HIV clusters over time in a statewide epidemic identified distinct cluster types, likely missed in cross-sectional analyses, demonstrating that not all clusters are equal. This knowledge challenges current perceptions of consistent cluster behavior over time and could improve molecular surveillance of local HIV epidemics to better inform public health strategies.
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Affiliation(s)
| | | | - Mark Howison
- Research Improving People’s Lives, Providence, RI, USA
| | | | | | | | | | | | | | | | | | - Utpala Bandy
- Rhode Island Department of Health, Providence, RI, USA
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Sokol NA, Alikhani A, Jao NC, Sharma E, Stroud LR. Reasons for Use of Electronic Cigarettes, Cigars, and Hookah in Pregnant Women in Rhode Island: A Preliminary Study. R I Med J (2013) 2023; 106:34-38. [PMID: 36706206 PMCID: PMC9933413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND The current study examined reasons pregnant women in Rhode Island use non-cigarette nicotine/tobacco products during and prior to pregnancy. METHODS Of the 124 pregnant women in Rhode Island enrolled in the study, 91% self-reported ever using e- cigarettes, hookah or cigars, and reasons for their use. We compared responses between participants who used these products during pregnancy (prenatal) and those who used prior to pregnancy (lifetime) for each product separately. RESULTS Participants reported using e-cigarettes as a cessation aid, hookah for entertainment, and cigars as a vehicle for marijuana consumption as primary reasons for use. There were no significant differences in reasons for using hookah or cigars between prenatal and lifetime users, but prenatal e-cigarette users were more likely to report affordability as a reason for use compared to lifetime e-cigarette users. CONCLUSIONS Differential reasons for use by tobacco product may have implications for targeted interventions in pregnant people in Rhode Island.
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Affiliation(s)
- Natasha A Sokol
- Center for Behavioral and Preventive Medicine at The Miriam Hospital, Department of Psychiatry and Human Behavior at Alpert Medical School of Brown University, Providence, RI
| | - Anna Alikhani
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Nancy C Jao
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | | | - Laura R Stroud
- Center for Behavioral and Preventive Medicine at The Miriam Hospital, Department of Psychiatry and Human Behavior at Alpert Medical School of Brown University, Providence, RI
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Zinkann P, Jenkins K, Lebrun N, Garcia L, Hiller C, Stair E. Implementation of a Standardized Template to Improve the Timeliness and Consistency of Early Case Reporting for Pediatric, Adolescent, and Young Adult Cancer Cases to the Rhode Island Cancer Registry. J Registry Manag 2023; 50:170-172. [PMID: 38504709 PMCID: PMC10945926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
- Paulette Zinkann
- Peers-Partners, Rhode Island Cancer Registry, Tanaq Support Services, LLC
| | - Kioka Jenkins
- Peers-Partners, Rhode Island Cancer Registry, Tanaq Support Services, LLC
| | - Nancy Lebrun
- Peers-Partners, Rhode Island Cancer Registry, Tanaq Support Services, LLC
| | - Lisa Garcia
- Peers-Partners, Rhode Island Cancer Registry, Tanaq Support Services, LLC
| | - Christina Hiller
- Peers-Partners, Rhode Island Cancer Registry, Tanaq Support Services, LLC
| | - Erin Stair
- Peers-Partners, Rhode Island Cancer Registry, Tanaq Support Services, LLC
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Weidele HR, Wightman R, St John K, Marchetti L, Bratberg J, Hallowell BD. Fentanyl and Fentanyl Analogs Detected Among Unintentional Opioid Involved Overdose Deaths in Rhode Island: January 2019-December 2021. R I Med J (2013) 2022; 105:64-66. [PMID: 36413456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Heidi R Weidele
- Senior Fatal Overdose Epidemiologist, Center for Health Data and Analysis (CHDA) at RIDOH
| | - Rachel Wightman
- Assistant Professor Emergency Medicine, Alpert Medical School of Brown University
| | | | - Louis Marchetti
- Center for Clinical Toxicology and Laboratory Support, Rhode Island State Health Laboratories
| | - Jeffrey Bratberg
- Department of Pharmacy Practice, University of Rhode Island College of Pharmacy
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Bhattarai L, MacAskill M, Bertrand T, Howe K, Chan PA, Bandy U. Innovative Approaches to Promoting Health Equity through HIV Prevention in Rhode Island. R I Med J (2013) 2022; 105:47-50. [PMID: 36300966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Lila Bhattarai
- Surveillance Manager, Center for HIV, Hepatitis, STD and TB, Rhode Island Department of Health
| | - Meghan MacAskill
- HIV Surveillance Epidemiologist, Center for HIV, Hepatitis, STD and TB, Rhode Island Department of Health
| | - Thomas Bertrand
- Chief, Center for HIV, Hepatitis, STD and TB, Rhode Island Department of Health
| | - Katharine Howe
- Prevention Program Manager, Center for HIV, Hepatitis, STD and TB, Rhode Island Department of Health
| | - Philip A Chan
- Consultant Medical Director, Center for HIV, Hepatitis, STD and TB, Rhode Island Department of Health
| | - Utpala Bandy
- Interim Director of Health, Rhode Island Department of Health
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Zang X, Bessey SE, Krieger MS, Hallowell BD, Koziol JA, Nolen S, Behrends CN, Murphy SM, Walley AY, Linas BP, Schackman BR, Marshall BDL. Comparing Projected Fatal Overdose Outcomes and Costs of Strategies to Expand Community-Based Distribution of Naloxone in Rhode Island. JAMA Netw Open 2022; 5:e2241174. [PMID: 36350649 PMCID: PMC9647481 DOI: 10.1001/jamanetworkopen.2022.41174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
IMPORTANCE In 2021, the state of Rhode Island distributed 10 000 additional naloxone kits compared with the prior year through partnerships with community-based organizations. OBJECTIVE To compare various strategies to increase naloxone distribution through community-based programs in Rhode Island to identify one most effective and efficient strategy in preventing opioid overdose deaths (OODs). DESIGN, SETTING, AND PARTICIPANTS In this decision analytical model study conducted from January 2016 to December 2022, a spatial microsimulation model with an integrated decision tree was developed and calibrated to compare the outcomes of alternative strategies for distributing 10 000 additional naloxone kits annually among all individuals at risk for opioid overdose in Rhode Island. INTERVENTIONS Distribution of 10 000 additional naloxone kits annually, focusing on people who inject drugs, people who use illicit opioids and stimulants, individuals at various levels of risk for opioid overdose, or people who misuse prescription opioids vs no additional kits (status quo). Two expanded distribution implementation approaches were considered: one consistent with the current spatial distribution patterns for each distribution program type (supply-based approach) and one consistent with the current spatial distribution of individuals in each of the risk groups, assuming that programs could direct the additional kits to new geographic areas if required (demand-based approach). MAIN OUTCOMES AND MEASURES Witnessed OODs, cost per OOD averted (efficiency), geospatial health inequality measured by the Theil index, and between-group variance for OOD rates. RESULTS A total of 63 131 simulated individuals were estimated to be at risk for opioid overdose in Rhode Island based on current population data. With the supply-based approach, prioritizing additional naloxone kits to people who use illicit drugs averted more witnessed OODs by an estimated mean of 18.9% (95% simulation interval [SI], 13.1%-30.7%) annually. Expanded naloxone distribution using the demand-based approach and focusing on people who inject drugs had the best outcomes across all scenarios, averting an estimated mean of 25.3% (95% SI, 13.1%-37.6%) of witnessed OODs annually, at the lowest mean incremental cost of $27 312 per OOD averted. Other strategies were associated with fewer OODs averted at higher costs but showed similar patterns of improved outcomes and lower unit costs if kits could be reallocated to areas with greater need. The demand-based approach reduced geospatial inequality in OOD rates in all scenarios compared with the supply-based approach and status quo. CONCLUSIONS AND RELEVANCE In this decision analytical model study, variations in the effectiveness, efficiency, and health inequality of the different naloxone distribution expansion strategies and approaches were identified. Future efforts should be prioritized for people at highest risk for overdose (those who inject drugs or use illicit drugs) and redirected toward areas with the greatest need. These findings may inform future naloxone distribution priority settings.
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Affiliation(s)
- Xiao Zang
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - Sam E. Bessey
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - Maxwell S. Krieger
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | | | | | - Shayla Nolen
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - Czarina N. Behrends
- Department of Population Health Sciences, Weill Cornell Medical College, New York, New York
| | - Sean M. Murphy
- Department of Population Health Sciences, Weill Cornell Medical College, New York, New York
| | - Alexander Y. Walley
- Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts
| | - Benjamin P. Linas
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Bruce R. Schackman
- Department of Population Health Sciences, Weill Cornell Medical College, New York, New York
| | - Brandon D. L. Marshall
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
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Chambers LC, Hallowell BD, Zang X, Rind DM, Guzauskas GF, Hansen RN, Fuchs N, Scagos RP, Marshall BDL. The estimated costs and benefits of a hypothetical supervised consumption site in Providence, Rhode Island. Int J Drug Policy 2022; 108:103820. [PMID: 35973341 PMCID: PMC10131249 DOI: 10.1016/j.drugpo.2022.103820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/26/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Overdose deaths have increased dramatically in the United States, including in Rhode Island. In July 2021, the Rhode Island government passed legislation supporting a two-year pilot program authorizing supervised consumption sites (SCSs) in response to this crisis. We estimated the costs and benefits of a hypothetical SCS in Providence, Rhode Island. METHODS We utilized a decision analytic mathematical model to compare costs and outcomes for people who inject drugs under two scenarios: (1) a SCS that includes syringe services provision, and (2) a syringe service program only (i.e., status quo). We assumed 0.95% of injections result in overdose, the SCS would serve 400 clients monthly and have a net cost of $783,899 annually, 46% of overdoses occurring outside of the SCS result in an ambulance run and 43% result in an emergency department (ED) visit, 0.79% of overdoses occurring within the SCS result in an ambulance run and ED visit, and the SCS would lead to a 25.7% reduction in fatal overdoses near the site. The model was developed from a modified societal perspective with a one-year time horizon. RESULTS A hypothetical SCS in Providence would prevent approximately 2 overdose deaths, 261 ambulance runs, 244 ED visits, and 117 inpatient hospitalizations for emergency overdose care annually compared to a scenario that includes a syringe service program only. The SCS would save $1,104,454 annually compared to the syringe service program only, accounting only for facility costs and short-term costs of emergency overdose care and ignoring savings associated with averted deaths. Influential parameters included the percentage of injections resulting in overdose, the total annual injections at the SCS, and the percentage of overdoses outside of the SCS that result in an ED visit. CONCLUSION A SCS in would result in substantial cost savings due to prevention of costly emergency overdose care.
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Affiliation(s)
- Laura C Chambers
- Drug Overdose Surveillance Program, Rhode Island Department of Health, Providence, Rhode Island, USA; Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island, USA.
| | - Benjamin D Hallowell
- Drug Overdose Surveillance Program, Rhode Island Department of Health, Providence, Rhode Island, USA
| | - Xiao Zang
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - David M Rind
- Institute for Clinical and Economic Review, Boston, Massachusetts, USA
| | - Greg F Guzauskas
- Comparative Health Outcomes, Policy, and Economics Institute, University of Washington, Seattle, Washington, USA
| | - Ryan N Hansen
- Comparative Health Outcomes, Policy, and Economics Institute, University of Washington, Seattle, Washington, USA
| | - Nathaniel Fuchs
- Drug Overdose Surveillance Program, Rhode Island Department of Health, Providence, Rhode Island, USA
| | - Rachel P Scagos
- Drug Overdose Surveillance Program, Rhode Island Department of Health, Providence, Rhode Island, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
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Hardy EJ, Palomaki GE, Sung CJ, Lambert-Messerlian GM. Surveillance of SARS-CoV-2 Antibodies in Early 2020 among Rhode Island Pregnancies. Ann Clin Lab Sci 2022; 52:788-795. [PMID: 36261192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Limited data are available on the performance of SARS-CoV-2 antibody assays and data collected during pregnancy vary widely. The objective of this study was to estimate the seroprevalence of antibodies against SARS-CoV-2 in pregnant individuals in Rhode Island and to evaluate whether the prevalence differed by month of collection, age, county of residence, or economic status as estimated by zip code. METHODS Pre-pandemic (2019) and early pandemic (2020) serum samples, collected for prenatal screening between 15 and 22 weeks of gestation, were analyzed utilizing two SARS-CoV-2 immunoglobulin G (IgG) automated assays that targeted the viral nucleocapsid (anti-N) or spike (anti-S) receptor binding domain proteins. RESULTS Among 756 pre-pandemic samples, one anti-S IgG and 13 anti-N IgG were identified. No samples were positive for both. Among 787 pandemic specimens, 16 (2.03%) were positive for both anti-N IgG and anti-S IgG. When stratified by month of collection, there was a significant increase in seropositivity rate (p=0.023). Seropositivity rates were associated with lower income levels (p=0.08) but this was not statistically significant. No trend by maternal age was found (p=0.70). CONCLUSIONS When a positive result was defined as both anti-N IgG and anti-S IgG, false positives were unlikely. Based on this methodology, serology could be utilized to monitor infection trends during pregnancy.
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Affiliation(s)
- Erica J Hardy
- Department of Medicine, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School at Brown University, Providence, RI, USA
- Department of Obstetrics and Gynecology, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Glenn E Palomaki
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - C James Sung
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Geralyn M Lambert-Messerlian
- Department of Obstetrics and Gynecology, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School at Brown University, Providence, RI, USA
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School at Brown University, Providence, RI, USA
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43
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St John K, Hom C, Weidele H. Naloxone Recipients in Rhode Island, January 2019-March 2022. R I Med J (2013) 2022; 105:67-70. [PMID: 36041027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Kristen St John
- Senior Public Health Epidemiologist for the Substance Use Epidemiology Program, Rhode Island Department of Health (RIDOH)
| | - Christina Hom
- Program Evaluator for the Drug Overdose Prevention Program, RIDOH
| | - Heidi Weidele
- Public Health Epidemiologist for the Substance Use Epidemiology Program, RIDOH
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St John K, Arias W. Improving Public Health Surveillance for Neonatal Abstinence Syndrome in Rhode Island. R I Med J (2013) 2022; 105:57-59. [PMID: 35882003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Kristen St John
- Senior Public Health Epidemiologist in the Center for Health Data and Analysis (CHDA), Rhode Island Department of Health (RIDOH)
| | - William Arias
- Maternal and Child Health Epidemiologist in CHDA, RIDOH
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Singh M, Novitsky V, Carpenter-Azevedo K, Howison M, Huard RC, King E, Kantor R. SARS-CoV-2 Variants in Rhode Island; May 2022 Update. R I Med J (2013) 2022; 105:6-11. [PMID: 35834172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Genomic surveillance allows identification of circulating SARS-CoV-2 variants. We provide an update on the evolution of SARS-CoV-2 in Rhode Island (RI). METHODS All publicly available SARS-CoV-2 RI sequences were retrieved from https://www.gisaid.org. Genomic analyses were conducted to identify variants of concern (VOC), variants being monitored (VBM), or non-VOC/non-VBM, and investigate their evolution. RESULTS Overall, 17,340 SARS-CoV-2 RI sequences were available between 2/2020-5/2022 across five (globally recognized) major waves, including 1,462 (8%) sequences from 36 non-VOC/non-VBM until 5/2021; 10,565 (61%) sequences from 8 VBM between 5/2021-12/2021, most commonly Delta; and 5,313 (31%) sequences from the VOC Omicron from 12/2021 onwards. Genomic analyses demonstrated 71 Delta and 44 Omicron sub-lineages, with occurrence of variant-defining mutations in other variants. CONCLUSION Statewide SARS-CoV-2 genomic surveillance allows for continued characterization of circulating variants and monitoring of viral evolution, which inform the local health force and guide public health on mitigation efforts against COVID-19.
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Affiliation(s)
- Manjot Singh
- Warren Alpert Medical School, Brown University, Providence, RI
| | | | | | - Mark Howison
- Research Improving People's Life, Providence, RI
| | - Richard C Huard
- Rhode Island Department of Health State Health Laboratories, Providence, RI
| | - Ewa King
- Rhode Island Department of Health State Health Laboratories, Providence, RI
| | - Rami Kantor
- Warren Alpert Medical School, Brown University, Providence, RI
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Rogers BG, Tao J, Almonte A, Toma E, Nagel K, Fain R, Napoleon SC, Maynard MA, Murphy M, Sarkar IN, Chan PA. Statewide evaluation of COVID-19 vaccine hesitancy in Rhode Island. PLoS One 2022; 17:e0268587. [PMID: 35648751 PMCID: PMC9159551 DOI: 10.1371/journal.pone.0268587] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/02/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Vaccines are effective in preventing Coronavirus Disease 2019 (COVID-19). Vaccine hesitancy defined as delay of acceptance or refusal of the vaccine is a major barrier to effective implementation. METHODS Participants were recruited statewide through an English and Spanish social media marketing campaign conducted by a local news station during a one-month period as vaccines were becoming available in Rhode Island (from December 21, 2020 to January 22, 2021). Participants completed an online survey about COVID-19 vaccines and vaccine hesitancy with constructs and items adopted from the Health Belief Model. RESULTS A total of 2,007 individuals completed the survey. Eight percent (n = 161) reported vaccine hesitancy. The sample had a median age of 58 years (interquartile range [IQR]: 45, 67), were majority female (78%), White (96%), Non-Hispanic (94%), employed (58%), and reported an annual individual income of $50,000 (59%). COVID-19 vaccine hesitancy was associated with attitudes and behaviors related to COVID-19. A one unit increase in concern about COVID-19 was associated with a 69% (Adjusted Odds Ratio: 0.31, 95% CI: 0.26-0.37) decrease in vaccine hesitancy. A one-level increase in the likelihood of getting influenza vaccine was associated with a 55% (AOR: 0.45 95% CI: 0.41-0.50) decrease in vaccine hesitancy. CONCLUSIONS COVID-19 vaccine hesitancy was relatively low in a state-wide survey in Rhode Island. Future research is needed to better understand and tailor messaging related to vaccine hesitancy.
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Affiliation(s)
- Brooke G. Rogers
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
- The Miriam Hospital, Providence, Rhode Island, United States of America
| | - Jun Tao
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
- The Miriam Hospital, Providence, Rhode Island, United States of America
| | - Alexi Almonte
- The Miriam Hospital, Providence, Rhode Island, United States of America
| | - Emily Toma
- The Miriam Hospital, Providence, Rhode Island, United States of America
| | - Katherine Nagel
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
| | - Robert Fain
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
| | - Siena C. Napoleon
- The Miriam Hospital, Providence, Rhode Island, United States of America
| | | | - Matthew Murphy
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
| | - Indra Neil Sarkar
- Rhode Island Quality Institute, Providence, Rhode Island, United States of America
- Center for Biomedical Informatics, Brown University, Providence, Rhode Island, United States of America
| | - Philip A. Chan
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
- The Miriam Hospital, Providence, Rhode Island, United States of America
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, Rhode Island, United States of America
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47
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Oh J, Lamy E. Cervical Precancer Among Rhode Island Women, 2018-2019: A Quick Report after the Rhode Island Cancer Surveillance Regulation Change. R I Med J (2013) 2022; 105:64-66. [PMID: 35617045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Junhie Oh
- Cancer Registry Administrator and the Senior Public Health Epidemiologist, Rhode Island Department of Health
| | - Eric Lamy
- Women's Cancer Screening Program Manager, Rhode Island Department of Health
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Albright JA, Meghani O, Lemme NJ, Owens BD. Characterization of Shoulder Instability in Rhode Island: Incidence, Surgical Stabilization, and Recurrence. R I Med J (2013) 2022; 105:56-62. [PMID: 35617044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE To characterize shoulder instability within the state of Rhode Island from 2011 to 2019. METHODS The Rhode Island All-Payer Claims Database (APCD) was used to identify all patients that make an insurance claim related to a shoulder instability event. All patients in the APCD with an ICD-9 code of 718.31, 718.32, or 831.00 through 831.19 or an ICD-10 code of S43.001 through S43.086 or M24.41 through M25.319 between January 1, 2011 and December 31, 2019 were selected. Chi-square analysis was used to compare age- and sex-delimited subgroups; multivariate logistic regression was used to assess for factors influencing rates of surgical intervention and recurrent instability; and Kaplan-Meier failure and log-rank analyses was used to analyze variation in the time to surgery and recurrence between age-delimited subgroups. RESULTS The incidence of overall shoulder instability (subluxations and dislocations) in Rhode Island was 62.20 instability events (95% CI, 60.61-63.78) per 100,000 person-years. The incidence of dislocations and subluxations were 49.46 injuries (95% CI, 48.05-50.88) and 12.73 injuries (95% CI, 12.02-13.45) per 100,000 person-years, respectively. Bivariate analysis demonstrated that male patients had significantly increased rates of surgical stabilization (6.36% vs. 2.80%) and recurrent instability (16.30% vs. 9.85%) compared to their female counterparts. However, after controlling for age at the primary instability event and the type and directionality of the instability, the difference in recurrence rates between males and females is no longer statistically significant (p = 0.326). Contrary to sex, age maintained its significance with those patients aged 20 and younger and 21-40 years at significantly increased odds of surgical stabilization (3.12 and 1.99, respectively) and experiencing a recurrent instability event (3.96 and 2.77, respectively). CONCLUSION These data characterize the epidemiology of shoulder instability within the state of Rhode Island and demonstrate how increasing age at a primary instability event decreases the likelihood of both surgical stabilization and rates of recurrence.
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Affiliation(s)
- J Alex Albright
- Warren Alpert Medical School of Brown University, Providence, RI
| | - Ozair Meghani
- Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI
| | - Nicholas J Lemme
- Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI
| | - Brett D Owens
- Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI
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49
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Jackson TL. Alcohol-related Liver Disease Among Adults in Rhode Island 2005-2021. R I Med J (2013) 2022; 105:69-71. [PMID: 35476742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Tracy L Jackson
- Senior Public Health Epidemiologist in the Center of Health Data and Analysis (CHDA) at the Rhode Island Department of Health (RIDOH)
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50
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Collins AB, Edwards S, McNeil R, Goldman J, Hallowell BD, Scagos RP, Marshall BDL. A rapid ethnographic study of risk negotiation during the COVID-19 pandemic among unstably housed people who use drugs in Rhode Island. Int J Drug Policy 2022; 103:103626. [PMID: 35228056 PMCID: PMC8849851 DOI: 10.1016/j.drugpo.2022.103626] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/09/2022] [Accepted: 02/12/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND The COVID-19 pandemic has greatly exacerbated the United States' overdose crisis. However, the overlapping impacts of COVID-19 and the overdose crisis have not been experienced equally, with unstably housed people who use drugs (PWUD) disproportionately impacted. Amid these changes, there is a need to understand how risk is experienced and managed among unstably housed PWUD to address health and social needs more effectively. METHODS This project draws on ethnographic research conducted from June 2020 to April 2021 in Rhode Island. Data include 39 in-depth interviews with unstably housed PWUD and approximately 50 h of ethnographic fieldwork conducted alongside street-based outreach workers. RESULTS COVID-19 risks were primarily contextualized in relation to participants' prior experiences of overdose events and adverse health outcomes. However, participants had varying levels of risk tolerance that were managed in ways that allowed them to reassert control and agency within the uncertainty of overlapping public health crises. Given participants' level of structural vulnerabilities, COVID-19 risk was managed alongside meeting their basic needs to survive. CONCLUSIONS Findings demonstrate how COVID-related public health measures (e.g., stay-at-home orders, service closures) reinforced participants' structural vulnerabilities in ways that increased their risk of health and social harms. Implementing and scaling up programs that meet the basic needs of individuals, including permanent housing, social supports, and overdose prevention interventions (e.g., supervised consumption sites) is critically needed to address intersecting risks faced by unstably housed PWUD.
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Affiliation(s)
- Alexandra B Collins
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States.
| | - Sarah Edwards
- Parent Support Network of Rhode Island, Warwick, Rhode Island, United States
| | - Ryan McNeil
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States; Program in Addiction Medicine, Yale School of Medicine, New Haven, Connecticut, United States
| | - Jacqueline Goldman
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States
| | | | - Rachel P Scagos
- Rhode Island Department of Health, Providence, Rhode Island, United States
| | - Brandon D L Marshall
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States
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