A Focused Screening and Clinical Intervention with Streamlined Outpatient Linkage for Hospitalized Patients with Opioid Use Disorder Experiencing Homelessness.

Background: Patients experiencing homelessness have higher rates of substance use and related mortality, often driven by opioid overdose. Conversely, opioid use disorder (OUD) is a leading risk factor for homelessness. Our goal was to test the efficacy of an electronic health record (EHR) screen in identifying this vulnerable population during hospitalization and to assess the feasibility of a bundled intervention in improving opioid safety. Methods: We assessed patients' housing status, substance use, previous MOUD treatment, barriers to MOUD treatment and readiness to take MOUD in and out of the hospital. For each post discharge follow up call, patients were asked about their MOUD status, barriers accessing treatment, current substance use, and housing status. We also assessed team members perceptions and experiences of the study. Results: We enrolled 32 patients with housing insecurity and OUD. The mean age was 44, the majority self-identified as male (78%), and mostly as White (56%) or Black (38%). At each follow up within the 6-months post-discharge, reach rates were low: 40% of enrollees answered at least 1 call and the highest reach rate (31% of patients) occurred at week 4. At the third and sixth-month follow ups, >50% of subjects still taking MOUD were also using opioids. Conclusion: Our clinician augmented EHR screen accurately identified inpatients experiencing OUD and PEH. This intervention showed high rates of attrition among enrolled patients, even after providing cellphones. The majority of patients who were reached remained adherent to MOUD though they reported significant barriers.

Defensive Behaviors During COVID-19 and the 2020–2021 Firearm Purchasing Surge: A Latent Class Analysis

Objective: This study examined the extent to which political beliefs and public health behaviors cluster together and define distinct groups of individuals and whether those groups differ on firearm purchasing behaviors. Methods: 6,404 US residents (Minnesota, n = 1,789;Mississippi, n = 1,418;New Jersey, n = 3,197) were recruited via Qualtrics panels. Participants were matched to 2010 census data. Results: Fit statistics determined a four-class solution fit the data best. The Liberal-Many Health Behaviors class had high probabilities of voting for President Biden, reporting more liberal political beliefs than other classes, and engaging in multiple health behaviors (e.g., mask wearing, vaccination). The Moderate-Few Health Behaviors class had high probabilities of voting for President Biden, reporting moderate political beliefs, and engaging in few health behaviors. The Conservative-Few Health Behaviors class had high probabilities of voting for former President Trump, reporting conservative political beliefs, and engaging in few health behaviors. The Conservative-Many Health Behaviors class had high probabilities of voting for former President Trump, having conservative political beliefs, and engaging in many health behaviors. Of the participants in the study who reported owning firearms, those in the Few Health Behavior classes were more likely to have purchased firearms during the purchasing surge, whereas those in the Many Health Behavior classes were likely to have become first-time firearm owners in 2020-2021. Lastly, the Few Health Behavior classes exhibited significantly less trust in the intentions of scientists. Conclusion: Different subgroups of firearm owners may evaluate and respond to risk differently, resulting in a pattern of adopting or avoiding a range of public health recommendations. Those who avoided mask wearing and COVID-19 vaccinations and who purchased firearms during the firearm purchasing surge appear to have less trust in science, highlighting the need for trusted messengers to increase the reach of behavioral interventions. [ FROM AUTHOR] Copyright of Journal of Social & Clinical Psychology is the property of Guilford Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Essential workers: Past month suicidal ideation and COVID-19 stress.

OBJECTIVE: This study examined if essential workers (EW) reported higher past month suicidal ideation (SI) and coronavirus-19 (COVID-19) stress than non-EW, explored if the association between EW status and SI is indirect through COVID stress, and tested whether EW who identified as black, indigenous, and people of color (BIPOC) experienced more past month SI and COVID stress than white EW. METHODS: Participants (N = 3500) were predominately white and female. COVID-19 was assessed with the COVID-19 subscale. RESULTS: EWs reported higher past month ideation and COVID-19 stress than non-EWs. EWs who identified as BIPOC reported higher past month ideation and higher fears about economic consequences and compulsive checking and reassurance seeking subscales compared to White EWs. CONCLUSION: EWs experience higher rates of SI and stress than non-EW; and BIPOC EWs experience higher SI and stress than White EWs. Accessibility of support should be a priority for this group at high risk for both the physical and emotional burden of COVID-19.

Suicidal Ideation Among Individuals Who Have Purchased Firearms During COVID-19.

INTRODUCTION: Given the increase in firearm purchases during the COVID-19 pandemic, this study seeks to determine the extent to which COVID-19 firearm purchasers differ in terms of suicide risk from nonfirearm owners and firearm owners who did not make a purchase during COVID-19. METHODS: Participants (N=3,500) were recruited through Qualtrics Panels to participate in an online survey examining methods for self-protection. ANCOVAs were utilized to assess suicidal ideation. Multivariate ANCOVAs were used to examine firearm storage practices and storage changes during COVID-19. Data were collected in late June and early July 2020, and analyses were conducted in July 2020. RESULTS: Individuals who purchased a firearm during COVID-19 more frequently reported lifetime, past-year, and past-month suicidal ideation than nonfirearm owners and firearm owners who did not make a purchase during COVID-19. COVID-19 purchasers with lifetime ideation were less likely to hide loaded firearms in a closet than those without lifetime ideation. COVID-19 purchasers with past-year or past-month ideation were more likely to use locking devices than COVID-19 purchasers without past-month ideation. CONCLUSIONS: In contrast to firearm owners more generally, COVID-19 firearm purchasers appear far more likely to have experienced suicidal ideation and appear less likely to use certain unsafe firearm storage methods but also report a greater number of storage changes during COVID-19 that made firearms less secure. Future research should seek to further understand those who purchased a firearm during COVID-19 and determine ways to increase secure storage among firearm owners.

Clinical outcomes and serologic response in solid organ transplant recipients with COVID-19: A case series from the United States.

The coronavirus disease 2019 (COVID-19) pandemic caused by SARS coronavirus 2 (SARS-CoV-2) has caused significant morbidity and mortality for patients and stressed healthcare systems worldwide. The clinical features, disease course, and serologic response of COVID-19 among immunosuppressed patients such as solid organ transplant (SOT) recipients, who are at presumed risk for more severe disease, are not well characterized. We describe our institutional experience with COVID-19 among 10 SOT patients, including the clinical presentation, treatment modalities, and outcomes of 7 renal transplant recipients, 1 liver transplant recipient, 1 heart transplant recipient, and 1 lung transplant recipient. In addition, we report the serologic response in SOT recipients, documenting a positive IgG response in all 7 hospitalized patients. We also review the existing literature on COVID-19 in SOT recipients to consolidate the current knowledge on COVID-19 in the SOT population for the transplant community.