Can Condoms Be Compelling? Examining the State Interest in Confiscating Condoms from Suspected Sex Workers

Confiscating condoms from suspected sex workers leaves them at risk for HIV/AIDS, other sexually transmitted diseases, and unwanted pregnancy. Yet, police officers in New York, Washington, D.C., and Los Angeles collect condoms from sex workers to use against them as evidence of prostitution. Sometimes, the condoms are taken solely for the purpose of harassment. These actions put sex workers at risk of contracting sexually transmitted diseases because they may continue to engage in sex work without using protection. In the landmark case of Griswold v. Connecticut, the U.S. Supreme Court established a fundamental privacy right in the use and access of contraceptive devices. While this right has been examined in the context of married couples and individuals, it has not been applied to the confiscation of condoms, a contraceptive device, by police officers. This Note shows that by taking condoms from suspected sex workers, police officers and departments are actually violating sex workers’ constitutional right to privacy, and, therefore, the practice must be abandoned

Can Condoms Be Compelling? Examining the State Interest in Confiscating Condoms from Suspected Sex Workers

Confiscating condoms from suspected sex workers leaves them at risk for HIV/AIDS, other sexually transmitted diseases, and unwanted pregnancy. Yet, police officers in New York, Washington, D.C., and Los Angeles collect condoms from sex workers to use against them as evidence of prostitution. Sometimes, the condoms are taken solely for the purpose of harassment. These actions put sex workers at risk of contracting sexually transmitted diseases because they may continue to engage in sex work without using protection. In the landmark case of Griswold v. Connecticut, the U.S. Supreme Court established a fundamental privacy right in the use and access of contraceptive devices. While this right has been examined in the context of married couples and individuals, it has not been applied to the confiscation of condoms, a contraceptive device, by police officers. This Note shows that by taking condoms from suspected sex workers, police officers and departments are actually violating sex workers’ constitutional right to privacy, and, therefore, the practice must be abandoned

Reach and effectiveness of a centralized navigation program for patients with positive fecal immunochemical tests requiring follow-up colonoscopy

Completion rates for follow-up colonoscopies after an abnormal fecal immunochemical test (FIT) are suboptimal in federally qualified health center (FQHC) settings. We implemented a screening intervention that included mailed FIT outreach to North Carolina FQHC patients from June 2020 to September 2021 and centralized patient navigation to support patients with abnormal FITs in completing follow-up colonoscopy. We evaluated the reach and effectiveness of navigation using electronic medical record data and navigator call logs detailing interactions with patients. Reach assessments included the proportion of patients successfully contacted by phone and who agreed to participate in navigation, intensity of navigation provided (including types of barriers to colonoscopy identified and total navigation time), and differences in these measures by socio-demographic characteristics. Effectiveness outcomes included colonoscopy completion, timeliness of follow-up colonoscopy (i.e., within 9 months), and bowel prep adequacy. Among 514 patients who completed a mailed FIT, 38 patients had an abnormal result and were eligible for navigation. Of these, 26 (68%) accepted navigation, 7 (18%) declined, and 5 (13%) could not be contacted. Among navigated patients, 81% had informational needs, 38% had emotional barriers, 35% had financial barriers, 12% had transportation barriers, and 42% had multiple barriers to colonoscopy. Median navigation time was 48.5 min (range: 24–277 min). Colonoscopy completion differed across groups – 92% of those accepting navigation completed colonoscopy within 9 months, versus 43% for those declining navigation. We found that centralized navigation was widely accepted in FQHC patients with abnormal FIT, and was an effective strategy, resulting in high colonoscopy completion rates

The Use of Three-Dimensional (3D) Biometric Measurements to Predict Additional Alignment Procedures in Total Ankle Replacement

Category: Ankle Arthritis Introduction/Purpose: Preoperative evaluation of ankle and hindfoot deformities in patients undergoing total ankle replacement (TAR) is challenging. Characterizing deformity based on conventional radiographs is limited by its two-dimensional (2D) nature and is influenced by anatomical and operator-related bias. The final decision to perform associated corrective alignment procedures, that include calcaneal osteotomies, midfoot and forefoot osteotomies/fusions, and soft tissue balancing, is made intraoperatively following insertion of the TAR components. The use of weightbearing cone beam CT (WB CBCT) images and three-dimensional (3D) biometric tools, encompassing the hindfoot alignment, foot tripod, and center of the ankle joint, may be an effective surgical planning instrument. In this retrospective study, we assessed the ability of these tools to predict additional procedures performed at the time of TAR. Methods: In this retrospective study, we enrolled 22 patients that underwent TAR and had preoperative WB CBCT studies. We excluded seven patients with isolated ankle CBCT images and three with metallic hindfoot implants. Patients demographics, type and number of additional alignment procedures were noted. The WB CBCT data sets were screened using built-in semi-automatic measurement software. 3D coordinates (x/y/z) were identified for the specific anatomical landmarks required to calculate Foot and Ankle Offset (FAO), which included the WB points of the first, fifth metatarsal heads and calcaneus, as well as the highest point of the talar dome. FAO is a representation of the torque (offset) between the hindfoot/forefoot midline and the center of the talus, and is given as a percentage of foot-length. Patients were then divided into varus and valgus hindfoot alignment groups accordingly to their measured FAO, using available literature FAO values for normally aligned feet (2.3%, ±2.9%). Results: We included 12 patients (6F/6 M), mean age 65 (range, 47-80). The mean preoperative FAO was 5.73 (CI -0.99 - 12.55). Seven patients had valgus and 5 patients had varus alignment of the hindfoot. The mean number of additional procedures was 2 (range, 0 to 5), and included: calcaneal osteotomy (58%), Achilles lengthening/Gastroc recession (58%), Cotton osteotomy (25%), First TMT fusion (17%), talonavicular fusion, naviculo-cuneiform fusion, and Brostrom procedure (8%). The FAO positively correlated with occurrence of additional alignment procedures (p=0.003). Patients with valgus hindfoot alignment had significantly increased number of additional procedures (2.7; CI 1.6 – 3.8) when compared to varus alignment patients (1.2; CI -0.1 – 2.5) (p=0.03), and were found to have a 1.8 fold greater chance to have a calcaneal osteotomy. Conclusion: This is the first study to evaluate the role of 3D biometric tools and semi-automatic WB CBCT measurements in the preoperative assessment of foot alignment in patients undergoing TAR. We found that increased Foot and Ankle Offset (FAO) significantly predicts the occurrence and number of additional alignment procedures, including calcaneal osteotomies. We believe that the use of biometrics and semi-automatic measurements, which account for the relationship between the center of the ankle and the tripod of the foot, can enhance the preoperative assessment, surgical planning and outcomes of TAR patients. Prospective and postoperative studies demonstrating correction are needed

Antibiotic-resistant organisms establish reservoirs in new hospital built environments and are related to patient blood infection isolates

Background: Healthcare-associated infections due to antibiotic-resistant organisms pose an acute and rising threat to critically ill and immunocompromised patients. To evaluate reservoirs of antibiotic-resistant organisms as a source of transmission to patients, we interrogated isolates from environmental surfaces, patient feces, and patient blood infections from an established and a newly built intensive care unit. Methods: We used selective culture to recover 829 antibiotic-resistant organisms from 1594 environmental and 72 patient fecal samples, in addition to 81 isolates from blood cultures. We conducted antibiotic susceptibility testing and short- and long-read whole genome sequencing on recovered isolates. Results: Antibiotic-resistant organism burden is highest in sink drains compared to other surfaces. Conclusions: These results highlight antibiotic-resistant organism reservoirs in hospital built environments as an important target for infection prevention in hospitalized patients

ISG15 mediates the function of extracellular vesicles in promoting ovarian cancer progression and metastasis

Abstract The interferon stimulated gene 15 (ISG15), a ubiquitin like protein and its conjugates have been implicated in various human malignancies. However, its role in ovarian cancer progression and metastasis is largely unknown. In high grade serous ovarian cancer (HGSOC), ascites is the major contributor to peritoneal metastasis. In this study, we identified significantly elevated ISG15 protein expression in HGSOC patient ascites, ascites derived primary ovarian cancer cells (POCCs), POCC small extracellular vesicles (sEVs) as well as metastatic tissue. Our results demonstrates that ISG15 increases exocytosis in ascites‐derived POCCs by decreasing the endosome‐lysosomal fusion, indicating a key role in sEV secretion. Further, knockdown (KD) of ISG15 resulted in a significant decrease in vesicles secretion from HGSOC cells and in vivo mouse models, leading to reduced HGSOC cell migration and invasion. Furthermore, our pre‐clinical mouse model studies revealed the influence of vesicular ISG15 on disease progression and metastasis. In addition, knockdown of ISG15 or using the ISG15 inhibitor, DAP5, in combination therapy with carboplatin showed to improve the platinum sensitivity in‐vitro and reduce tumour burden in‐vivo. We also found that ISG15 expression within sEV represents a promising prognostic marker for HGSOC patients. Our findings suggest that ISG15 is a potential therapeutic target for inhibiting progression and metastasis in HGSOC and that vesicular ISG15 expression could be a promising biomarker in the clinical management of ovarian cancer. Significance: High‐grade serous ovarian cancer (HGSOC) has high morbidity and mortality rates, but its progression and metastasis are still poorly understood, and there is an urgent need for early detection and targeted therapies. Our study presents novel findings that implicate ISG15‐mediated vesicular proteins in the advancement and spread of HGSOC. These results offer pre‐clinical evidence of potential new molecular targets, prognostic markers and therapeutic strategies for HGSOC that could ultimately enhance patient survival

Implementation strategies in the Exploration and Preparation phases of a colorectal cancer screening intervention in community health centers

Abstract Background Adoption of colorectal cancer (CRC) screening has lagged in community health center (CHC) populations in the USA. To address this implementation gap, we developed a multilevel intervention to improve screening in CHCs in our region. We used the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to guide this effort. Here, we describe the use of implementation strategies outlined in the Expert Recommendations for Implementing Change (ERIC) compilation in both the Exploration and Preparation phases of this project. During these two EPIS phases, we aimed to answer three primary questions: (1) What factors in the inner and outer contexts may support or hinder colorectal cancer screening in North Carolina CHCs?; (2) What evidence-based practices (EBPs) best fit the needs of North Carolina CHCs?; and (3) How can we best integrate the selected EBPs into North Carolina CHC systems? Methods During the Exploration phase, we conducted local needs assessments, built a coalition, and conducted local consensus discussions. In the Preparation phase, we formed workgroups corresponding to the intervention’s core functional components. Workgroups used cyclical small tests of change and process mapping to identify implementation barriers and facilitators and to adapt intervention components to fit inner and outer contexts. Results Exploration activities yielded a coalition of stakeholders, including two rural CHCs, who identified barriers and facilitators and reached consensus on two EBPs: mailed FIT and navigation to colonoscopy. Stakeholders further agreed that the delivery of those two EBPs should be centralized to an outreach center. During Preparation, workgroups developed and refined protocols for the following centrally-delivered intervention components: a registry to identify and track eligible patients, a centralized system for mailing at-home stool tests, and a process to navigate patients to colonoscopy after an abnormal stool test. Conclusions This description may be useful both to implementation scientists, who can draw lessons from applied implementation studies such as this to refine their implementation strategy typologies and frameworks, as well as to implementation practitioners seeking exemplars for operationalizing strategies in early phases of implementation in healthcare

Additional file 1 of Implementation strategies in the Exploration and Preparation phases of a colorectal cancer screening intervention in community health centers

Additional file 1. Adherence to reporting guidelines. Description of project adherence to reporting guidelines as outlined in Proctor, E.K., Powell, B.J. & McMillen, J.C. Implementation strategies: recommendations for specifying and reporting. Implementation Sci 8, 139 (2013)