COVID-19 mitigation for high-risk populations in Springfield Massachusetts USA: a health systems approach.

BACKGROUND: Numerous reports have demonstrated the disproportionate impact that COVID-19 has had on vulnerable populations. Our purpose is to describe our health care system's response to this impact. METHODS: We convened a Workgroup with the goal to mitigate the impact of COVID-19 on the most medically vulnerable people in Springfield, Massachusetts, USA, particularly those with significant social needs. We did this through (1) identifying vulnerable patients in high-need geographic areas, (2) developing and implementing a needs assessment/outreach tool tailored to meet cultural, linguistic and religious backgrounds, (3) surveying pharmacies for access to medication delivery, (4) gathering information about sources of food delivery, groceries and/or prepared food, (5) gathering information about means of travel, and (6) assessing need for testing. We then combined these six elements into a patient-oriented branch and a community outreach/engagement branch. CONCLUSIONS: Our highly intentional and methodical approach to patient and community outreach with a strong geographic component has led to fruitful efforts in COVID-19 mitigation. Our patient-level outreach engages our health centers' clinical teams, particularly community health workers, and is providing the direct benefit of material and service resources for our at-risk patients and their families. Our community efforts leveraged existing relationships and created new partnerships that continue to inform us-healthcare entities, healthcare employees, and clinical teams-so that we can grow and learn in order to authentically build trust and engagement.

Epidemiology and Treatment of Hepatitis B in Prisoners.

PURPOSE OF REVIEW: The review details recent literature reports regarding Hepatitis B Virus (HBV) and, in particular, Hepatitis B prevalence/incidence in incarcerated populations around the world. Furthermore, the review will summarize the national/international guidelines regarding HBV and look at diagnosis, vaccination, treatment, and linkage to care after release. RECENT FINDINGS: HBV affects prisoners at a much higher rate than the general populations. Many who are at increased risk for HBV infection are also at increased risk for incarceration. Incarcerated settings also have higher rates of HBV transmission. SUMMARY: Incarcerated individuals should be immunized if they are not already immune to HBV. Increased access to safe injecting and tattoo paraphernalia, condoms, and personal hygiene equipment could reduce the spread of HBV and other blood-borne and sexually transmitted infections. Future research should focus on ways to prevent the spread of HBV and similar viruses in incarcerated settings in order to protect incarcerated individuals and the general public. Research on effective linkage to community HBV care following release is needed.

Age dependent forebrain structural changes in mice deficient in the autism associated gene Met tyrosine kinase.

The MET tyrosine kinase has been identified as a susceptibility gene in patients with autism spectrum disorders. MET is expressed in the forebrain during prenatal and postnatal development. After birth, MET participates in dendritic outgrowth and circuit formation. Alterations in neuronal development, particularly in the cerebral cortex, may contribute to the pathology of developmental disorders, including autism. Patients with autism can exhibit abnormal cortical volumes and head circumferences. We tested the hypothesis that impaired Met signaling during development alters forebrain structure. We have utilized a conditional mutant mouse line which expresses a kinase-dead Met restricted to the cerebral cortex and hippocampal structures. In these mice, we have used magnetic resonance imaging (MRI) to analyze the structure of the cerebral cortex and related structures across postnatal development. We found that the rostral cortex, caudal hippocampus, dorsal striatum, thalamus, and corpus callosum were all larger in adult, but not juvenile, mutant mice relative to control mice. The specificity of the changes suggests that aberrant expansion of the forebrain is consistent with continued axonal and dendritic growth, potentially leading to improper circuit formation and maintenance.