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The United States incarcerates more people than any other country in the world. The scale of mass incarceration ensures that almost all practicing physicians will treat formerly incarcerated patients. Yet the majority of physicians receive little training on this topic. In this paper, we will outline the need for expanded education on the interface between incarceration and health, describe initiatives taking place within the New York City jail system and nationally, and describe future directions for curriculum development. We conclude by highlighting the important role health care workers can play in transforming our criminal justice system and ending mass incarceration. [ABSTRACT FROM AUTHOR]

Key Points: Question: Among people receiving care in opioid treatment programs, does facilitated telemedicine for hepatitis C treatment increase cure rates compared with standard-of-care referral to hepatitis specialists? Findings: Cure percentages were 90.2% in telemedicine and 39.4% in referral, with an estimated logarithmic odds ratio of the study group effect of 2.9. Among cured participants, illicit drug use decreased significantly. We observed minimal reinfections during 2 years of follow-up. Meaning: Facilitated telemedicine integrated into opioid treatment programs resulted in significantly higher cure rates, with significant reductions in illicit drug use and minimal reinfections; facilitated telemedicine increases hepatitis C treatment access for underserved populations. Importance: Facilitated telemedicine may promote hepatitis C virus elimination by mitigating geographic and temporal barriers. Objective: To compare sustained virologic responses for hepatitis C virus among persons with opioid use disorder treated through facilitated telemedicine integrated into opioid treatment programs compared with off-site hepatitis specialist referral. Design, Setting, and Participants: Prospective, cluster randomized clinical trial using a stepped wedge design. Twelve programs throughout New York State included hepatitis C–infected participants (n = 602) enrolled between March 1, 2017, and February 29, 2020. Data were analyzed from December 1, 2022, through September 1, 2023. Intervention: Hepatitis C treatment with direct-acting antivirals through comanagement with a hepatitis specialist either through facilitated telemedicine integrated into opioid treatment programs (n = 290) or standard-of-care off-site referral (n = 312). Main Outcomes and Measures: The primary outcome was hepatitis C virus cure. Twelve programs began with off-site referral, and every 9 months, 4 randomly selected sites transitioned to facilitated telemedicine during 3 steps without participant crossover. Participants completed 2-year follow-up for reinfection assessment. Inclusion criteria required 6-month enrollment in opioid treatment and insurance coverage of hepatitis C medications. Generalized linear mixed-effects models were used to test for the intervention effect, adjusted for time, clustering, and effect modification in individual-based intention-to-treat analysis. Results: Among 602 participants, 369 were male (61.3%); 296 (49.2%) were American Indian or Alaska Native, Asian, Black or African American, multiracial, or other (ie, no race category was selected, with race data collected according to the 5 standard National Institutes of Health categories); and 306 (50.8%) were White. The mean (SD) age of the enrolled participants in the telemedicine group was 47.1 (13.1) years; that of the referral group was 48.9 (12.8) years. In telemedicine, 268 of 290 participants (92.4%) initiated treatment compared with 126 of 312 participants (40.4%) in referral. Intention-to-treat cure percentages were 90.3% (262 of 290) in telemedicine and 39.4% (123 of 312) in referral, with an estimated logarithmic odds ratio of the study group effect of 2.9 (95% CI, 2.0-3.5; P <.001) with no effect modification. Observed cure percentages were 246 of 290 participants (84.8%) in telemedicine vs 106 of 312 participants (34.0%) in referral. Subgroup effects were not significant, including fibrosis stage, urban or rural participant residence location, or mental health (anxiety or depression) comorbid conditions. Illicit drug use decreased significantly (referral: 95% CI, 1.2-4.8; P =.001; telemedicine: 95% CI, 0.3-1.0; P <.001) among cured participants. Minimal reinfections (n = 13) occurred, with hepatitis C virus reinfection incidence of 2.5 per 100 person-years. Participants in both groups rated health care delivery satisfaction as high or very high. Conclusions and Relevance: Opioid treatment program–integrated facilitated telemedicine resulted in significantly higher hepatitis C virus cure rates compared with off-site referral, with high participant satisfaction. Illicit drug use declined significantly among cured participants with minimal reinfections. Trial Registration: ClinicalTrials.gov Identifier: NCT02933970 This study discusses whether facilitated telemedicine for hepatitis C treatment increases cure rates compared with standard-of-care referral to hepatitis specialists. [ABSTRACT FROM AUTHOR]

Presents an article previously printed in the June 21, 1902 issue of the 'Journal of the American Medical Association.' 'What of the Future?,' an address delivered before the obstetrics and disease of women session at the 53rd annual meeting of the American Medical Association in Saratoga Springs, New York.

Presents a paper that appeared in the "Journal of the American Medical Association" on April 23, 1904. Report that the Elsberg bill abolishing the office of coroner in Greater New York has been passed; Power of investigation that remains to the coroners still in office; Assertion that miscarriages of justice have occurred due to the inadequacy of coroners; Way that deaths will be assessed by medical examiners.

A reprint of the article "Communication and the Journals," which originally appeared in a 1967 issue of the journal, is presented. A question about whether medical journals aid communication is addressed, along with a symposium on Biomedical Communications which was held in New York, New York on April 4-6, 1966. The number of medical periodicals that are available for physicians and others to read is examined, along with research about the value of small Information Exchange Groups.

Importance: Although acute HIV infection contributes disproportionately to onward HIV transmission, HIV testing has not routinely included screening for acute HIV infection.Objective: To evaluate the performance of an HIV antigen/antibody (Ag/Ab) combination assay to detect acute HIV infection compared with pooled HIV RNA testing.Design, Setting, and Participants: Multisite, prospective, within-individual comparison study conducted between September 2011 and October 2013 in 7 sexually transmitted infection clinics and 5 community-based programs in New York, California, and North Carolina. Participants were 12 years or older and seeking HIV testing, without known HIV infection.Exposures: All participants with a negative rapid HIV test result were screened for acute HIV infection with an HIV Ag/Ab combination assay (index test) and pooled human immunodeficiency virus 1 (HIV-1) RNA testing. HIV RNA testing was the reference standard, with positive reference standard result defined as detectable HIV-1 RNA on an individual RNA test.Main Outcomes and Measures: Number and proportion with acute HIV infections detected.Results: Among 86,836 participants with complete test results (median age, 29 years; 75.0% men; 51.8% men who have sex with men), established HIV infection was diagnosed in 1158 participants (1.33%) and acute HIV infection was diagnosed in 168 participants (0.19%). Acute HIV infection was detected in 134 participants with HIV Ag/Ab combination testing (0.15% [95% CI, 0.13%-0.18%]; sensitivity, 79.8% [95% CI, 72.9%-85.6%]; specificity, 99.9% [95% CI, 99.9%-99.9%]; positive predictive value, 59.0% [95% CI, 52.3%-65.5%]) and in 164 participants with pooled HIV RNA testing (0.19% [95% CI, 0.16%-0.22%]; sensitivity, 97.6% [95% CI, 94.0%-99.4%]; specificity, 100% [95% CI, 100%-100%]; positive predictive value, 96.5% [95% CI, 92.5%-98.7%]; sensitivity comparison, P < .001). Overall HIV Ag/Ab combination testing detected 82% of acute HIV infections detectable by pooled HIV RNA testing. Compared with rapid HIV testing alone, HIV Ag/Ab combination testing increased the relative HIV diagnostic yield (both established and acute HIV infections) by 10.4% (95% CI, 8.8%-12.2%) and pooled HIV RNA testing increased the relative HIV diagnostic yield by 12.4% (95% CI, 10.7%-14.3%).Conclusions and Relevance: In a high-prevalence population, HIV screening using an HIV Ag/Ab combination assay following a negative rapid test detected 82% of acute HIV infections detectable by pooled HIV RNA testing, with a positive predictive value of 59%. Further research is needed to evaluate this strategy in lower-prevalence populations and in persons using preexposure prophylaxis for HIV prevention. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the risk factors for new asthma diagnoses and event-related post-traumatic stress (PTS) symptoms in adults after 5 to 6 years of exposure to the September 11, 2001 terrorist attack on the World Trade Center (WTC) in New York. The study enrolled in 2003-2004 71,437 adults which include rescue and recovery worker, lower Manhattan resident, lower Manhattan office worker and passersby eligibility groups. The study found that 10.2% of participants with no history of asthma reported new asthma diagnoses following exposure to the terror attack. It was also found that intense dust cloud exposure during the attack was a major contributor to new asthma diagnoses in the groups studied. Also noted are the factors associated with PTS symptoms after exposure.

The article presents a study that determined the impact of standardized order seats (SOSs) and intensive clinical case management (ICCM) on outcomes in community-acquired pneumonia (CAP). Three blocks with 110 patients each were studied at the Winthrop University Hospital in Long Island, New York from November 2002 to February 2005. Patients in the first block were given conventional treatment. SOSs supported by ICCM were applied to the patients in second block while SOSs without the intervention of ICCM were used for block three patients. Results of the study showed that the length of hospital stay (LOS) in block two differs from block one and block three indicating that the combined intervention of SOS and ICCM led to the reduction in LOS while maintaining care.

Observations on writing discharge summaries of deceased patients in a nursing home. How nobody will read this summary; Charts, forms, and paper work indicating the progress of patient Ruby R. for her length of stay at Jewish Home; How she arrived at the Jewish Home, an old age home, in Rochester, New York.

Hypothesis Having a parent with the human immunodeficiency virus has a significant negative impact on an adolescent child's adjustment. Objective To assess the adjustment of adolescent children to having a parent with the human immunodeficiency virus over 6 years, following the delivery of a coping skills intervention. Design A randomized controlled trial with repeated evaluations that was analyzed with an intention-to-treat analysis. A skill-based intervention was delivered in 3 modules over 24 sessions, with the third module being delivered only if parents died. Setting and Patients A representative sample of parents with the human immunodeficiency virus (n = 307) and their adolescent children (n = 423) was recruited from the Division of AIDS Services in New York City; 51.5% (n = 158) of the parents died. Main Outcome Measures Employment and school enrollment, receiving public welfare support, early parenthood, mental health symptoms, and the quality of romantic relationships. Results Over 6 years, significantly more adolescents in the intervention condition than the control condition were employed or in school (82.58% vs 68.94%), were less likely to receive public welfare payments (25.66% vs 36.65%), were less likely to have psychosomatic symptoms (mean, 0.24 vs 0.31), were more likely to report better problem-solving and conflict resolution skills in their romantic relationships (mean score, 4.38 vs 4.20), expected to have a partner with a good job (mean, 4.57 vs 4.19), and expected to be married when parenting (mean, 3.05 vs 2.40). With marginal significance, the percentage of parents in the intervention condition (34.6%) was less than in the control condition (44.1%). Conclusion Physicians must consider the psychosocial consequences of illness-related challenges on children and provide interventions. [ABSTRACT FROM AUTHOR]

Background Although research has suggested that extensive television viewing may be associated with sleep problems, the direction of this association has not yet been determined. Objective To investigate directional hypotheses regarding the association between television viewing and sleep problems during adolescence and early adulthood. Design The Children in the Community Study, a prospective longitudinal investigation. Participants and Setting A community-based sample of 759 mothers from upstate New York and their offspring were interviewed during the early adolescence (mean age, 14 years), middle adolescence (mean age, 16 years), and early adulthood of the offspring (mean age, 22 years). Main Outcome Measures Television viewing and sleep problems during adolescence and early adulthood measured using the Disorganizing Poverty Interview and the age-appropriate versions of the Diagnostic Interview Schedule for Children. Results Adolescents who watched 3 or more hours of television per day during adolescence were at a significantly elevated risk for frequent sleep problems by early adulthood. This elevation in risk remained significant after offspring age, sex, previous sleep problems, offspring psychiatric disorders, offspring neglect, parental educational level, parental annual income, and parental psychiatric symptoms were controlled statistically. Adolescents who reduced their television viewing from 1 hour or longer to less than 1 hour per day experienced a significant reduction in risk for subsequent sleep problems. Sleep problems during adolescence were not independently associated with subsequent television viewing when prior television viewing was controlled. Conclusion Extensive television viewing during adolescence may contribute to the development of sleep problems by early adulthood. [ABSTRACT FROM AUTHOR]

Women in New York State are heavily affected by the human immunodeficiency virus (HIV) epidemic. New York has had the largest number of births to HIV-infected pregnant women in the United States. Data collected as part of the Survey of Childbearing Women have been valuable for assessing the impact of the disease on the women of New York. To assess HIV prevalence trends among child-bearing women in New York State. An unlinked HIV seroprevalence study was conducted among all women residing in and giving birth in New York State from 1988 through 2000. Trend and cohort analyses were conducted. HIV prevalence, defined as the number of HIV-positive specimens divided by the total number of HIV-positive and HIV-negative specimens, by geographic region, racial/ethnic group, and maternal age cohort. Trends indicated a steady decline in HIV prevalence in New York State. New York City had a 49% decrease in prevalence between 1988 through 1989 and 1999 through 2000, and the rest of the state showed a 24% decline. However, birth cohort analysis indicated different patterns in trend by subpopulation, with some groups experiencing little or no decline. This study reports on the only statewide population-based HIV prevalence data currently available for childbearing women; these data have been a valuable tool for monitoring trends, targeting resources, and evaluating programs and policies. [ABSTRACT FROM AUTHOR]

Presents reports from the U.S. Centers for Disease Control and Prevention. Injuries and illnesses among New York City fire department rescue workers after responding to the World Trade Center attacks; New classification for deaths and injuries involving terrorism; Recollections of 9/11 from medical officers of the New York City fire department.

Examines the impact of color blindness on the ability to detect the presence of blood in body fluids by color-blinds in New York. Comparison between the recognition ability of color-blind and noncolor-blind individuals; Importance of an accurate recognition on the presence of blood in body fluids; Characteristics of a reg-green color-blind person.

Discusses the internship of physician William Carlos Williams at the New York Nursery and Child's Hospital between 1908 and 1909, wherein he engaged in a protracted battle with the hospital's administration over an order that he endorse a report of hospital bills to be sent to the state of New York. Moral convictions resulting in abrupt resignation; Uncomfortable role of 'whistle-blower.'

Compares playground hazards in high- and low-income neighborhoods in New York City. Categories of total hazards per play area; Types of hazards surveyed; Most common playground hazards; Higher potential hazards per play area in the low-income group.

The article discusses a report on the hospitalization of patients due to influenza A H1N1 in New York City in May 2009. The report, which was issued by the New York City Department of Health and Mental Hygiene, summarized the findings of a review on the demographics of the first hospitalized patients due to H1N1 influenza. It described the clinical course and severity of disease in each patient, along with the use of antiviral medications. According to U.S. Centers for Disease Control and Prevention (CDC), the report demonstrated the impact of antiviral medication on the length of hospital stay, although it failed to note the association between rapid treatment and shorter hospitalization.

The article recalls medical news published on June 17, 1911. The oldest prescription in the U.S., dated probably not later than 1500 B.C., has been listed under Accession Number 988 at the New York Metropolitan Museum of Arts in New York City. The Department of Public Safety, Office of the Superintendent of Hospital, has been using a letterhead with a smoking chimney drawing.