In 2022, San Joaquin County had approximately 2,319 unhoused/unsheltered individuals, with 66% residing in Stockton. Studies have found that approximately 75% of unhoused individuals reported drug use of any kind and 12% reported opioid use. Additionally, drug overdosedeaths increased in the United States by more than 30% from 2019 to 2020. Transmission rates of infections associated with injection drug use have also been increasing. Harm reduction services, including syringe exchange and naloxone distribution, have been shown toreduce the rates of disease transmission and drug overdose death within communities.
In 2016, the rate of drug-induced deaths was 56% higher in San Joaquin County than the California state average. Developed in July 2020, The Stockton Harm ReductionProgram (SHRP) provides sterile syringes and injection equipment, condoms, naloxone, hygiene products, and referrals for health and housing services to people in San Joaquin County. The purpose of this study is to determine the impact of a mobile harm reduction program on usage of sterilesyringes and naloxone by program participants.
Determine which elements of a lactating patient’s clinical presentation, including breast pump use and symptoms, are associated with a diagnosis of nipple thrush.
To evaluate the consistency of contraceptionplan identified at delivery hospitalization withreported contraception use over 6 monthspostpartum.
The primary aim was to examining abortion-trained physician perspectives on barriers toabortion access and their views on physicians'roles in the legislative regulation of abortion.
The secondary aim was to elicit theperspectives and experiences of abortion-trained physicians to understand the effectsof legislation on their ability to providepatients with comprehensive reproductivecare.
Neurofibromatosis type 1 (NF1) is an inherited tumor syndrome caused by heterozygous germline mutations in the NF1 gene, occurring in approximately 1/2600 individuals. A subset of patients with neurofibromatosis type 1 (NF1) develop juvenile xanthogranulomas (JXGs), a non-Langerhans cell histiocytosis, and some of these patients also develop juvenile myelomonocytic leukemia (JMML).Yet, these associations are poorly delineated.JXG is a benign proliferation of non-Langerhans cells histiocytes characterized by small yellow/brown papulonodules ranging from 1-20 mm in size. JMML is a mixed myeloproliferative-myelodysplastic disorder that affects children, most often before age 6.4. The first and only systematic review on this described therisk of developing JMML 20 to 30 times higher in patients with NF1 with JXG lesions compared to those without JXG. Since then, mostly isolated case reports have either refuted or confirmed this triple association.
Racial inequities in medicine have impacted health outcomes in various communities. These inequities have been documented in journals to highlight racial inequities in health status, racial inequities in clinical algorithms, and racial identity and health. We conducted a review of literature and selected 95 articles to analyze and summarize in an annotated bibliography. The annotated bibliography was sorted into four categories: racial inequality in health status, racial inequality in clinical algorithms, racial identity and health (ex. mental health, development, schooling, etc.) including biracial and multiracial individuals, and the impact of racism on health. These articles highlight a theme of racial inequities in policy making, racial perceptions which influence clinical decision making, and the use of race as a sole indicator for diagnosis and treatment options in clinical algorithms. Racist perceptions against non-white patients were found to negatively influence clinical decision making in emergency settings.
The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in an unprecedented global “lockdown,” which has confined millions to mandatory isolation or self-quarantining in an effort to limit virus transmission. This has led to major socioeconomic disruptions, including travel restrictions and the closure of schools and businesses. Quarantine measures and the closure of gymnasiums, public pools, and exercise facilities have disrupted the exercise/physical activity (EPA) routines of millions of people. Primary care physicians (PCPs) serve as frontline health workers as patients continue to visit them for COVID-19 and non-COVID-19 healthcare needs. Because regular EPA has proven health benefits, it is essential that PCPs are prepared to adequately counsel and offer EPA recommendations to their patients during the COVID-19 pandemic. In 2015, the World Health Organization (WHO) recommended that adults aged 18-64 should perform at least 150 minutes/week of moderate-intensity aerobic activity or 75 minutes/week of vigorous-intensity aerobic activity. EPA has been shown to have wide-ranging positive effects on physical and mental health. Regular EPA is associated with decreased rates of major chronic diseases, such as hypertension, diabetes, and coronary heart disease. Regular EPA also has been shown to have favorable effects on immune function and mental health. More recently, it also has been suggested that regular EPA can reduce the risk of acute respiratory distress syndrome, a leading cause of mortality in COVID-19 patients. Given the many potential health benefits of regular EPA, PCPs should counsel their patients about regular EPA and recommend it to them during the COVID-19 pandemic. The fluid nature of the evolving COVID-19 outbreak has resulted in unique quarantine and social distancing guidelines in different countries, states, and locales. In consideration of the EPA recommendations from the American College of Sports Medicine and the WHO, and in consideration of the ongoing need for some albeit varying quarantine and social distancing guidelines, we propose PCPs offer their patients the following EPA counseling and recommendations during the COVID-19 pandemic.
As of 2019, there were 567,715 Americans without housing, and California reported the largest unhoused population in the country.1 In the past 2 years, the rate of unhoused people in California has risen 16%, which is the second highest in the country.1 Many reports have shown that the unhoused population is particularly vulnerable to infectious disease epidemics and pandemics due to lack of control of their surroundings, disproportionate resource allocation, and broken communication.2 While there have been many initiatives started to try and combat these inequities, there is little research about communication and the dissemination of information to the unhoused population.3 As the guidelines for COVID-19 are constantly changing, there is a need for a better system of communication within this vulnerable population to ensure that they receive timely, accurate updates to help reduce their risk of contracting or spreading COVID-19.
• People experiencing homelessness (PEH) are a vulnerable population during the COVID-19 pandemic due to preexistingcomorbidities, transience, and distrust of the medical system.• Prior work has demonstrated that The Housing First (HF) model has led to more stable housing, increased outpatienttreatment and primary care physician (PCP) visits, and fewer emergency room visits and hospitalizations.• During the COVID-19 emergency response, hotel rooms across California were re-purposed to house PEH.• The Encampment Med Team, a group of volunteer medical students sworn in as Disaster Service Workers, employed agrassroots approach through routine site visits to encampment and street sites in Sacramento.
California’s Family Planning Access Care and Treatment (Family PACT) program was established to ensure that all California residents have access to desired contraceptive service, regardless of immigration status. Many California residents speak Spanish.
