Homeless Vulnerability During an Opioid Epidemic: Assessing the Mortality Risk Among People Experiencing Homelessness in Southern California.

People experiencing homelessness suffer from a risk of mortality three to four times that of the general population, with drug-induced overdose replacing HIV as the emerging epidemic. This study assessed markers of mortality among people experiencing homelessness (N=157) in Orange County, CA during the Fall of 2016. We utilized the Vulnerability Index, an eight-question survey, to identify factors that may affect mortality risk among individuals experiencing homelessness and included two additional questions to identify potential risk of drug-induced overdose. Eighty-three percent of participants reported more than one heightened mortality risk marker and 64% may be at higher risk of drug-induced overdose. Given the state of the opioid epidemic, there is pressing need to couple public health interventions targeting people experiencing homelessness with harm reduction efforts including naloxone distribution (opioid-induced overdose reversal medication) and syringe exchange programs.

Transitions Clinic Network: Challenges And Lessons In Primary Care For People Released From Prison.

Low-income and minority communities are disproportionately affected by incarceration, which exacerbates health disparities. Through enhanced primary care, the Transitions Clinic Network (TCN) seeks to improve the health of people with chronic conditions who return to their communities from prison. Using TCN data, we assessed the impact of early engagement in primary care and referral from correctional systems to TCN on the use of acute care (emergency department visits and hospitalizations) and recidivism. Of 751 patients, 29.8 percent were referred by correctional partners, and 52.7 percent were engaged in TCN care within one month after release. In the twelve months after release, patients referred by correctional partners had fewer acute care visits, compared to those referred by community-based partners, while early engagement was associated with more acute care visits. Neither referral by correctional partners nor early engagement was significantly associated with recidivism. Our findings suggest that health equity for this vulnerable population could be achieved through improved coordination between correctional and community health care systems.

Dental impressions using 3D digital scanners: virtual becomes reality.

The technologies that have made the use of three-dimensional (3D) digital scanners an integral part of many industries for decades have been improved and refined for application to dentistry. Since the introduction of the first dental impressioning digital scanner in the 1980s, development engineers at a number of companies have enhanced the technologies and created in-office scanners that are increasingly user-friendly and able to produce precisely fitting dental restorations. These systems are capable of capturing 3D virtual images of tooth preparations, from which restorations may be fabricated directly (ie, CAD/CAM systems) or fabricated indirectly (ie, dedicated impression scanning systems for the creation of accurate master models). The use of these products is increasing rapidly around the world and presents a paradigm shift in the way in which dental impressions are made. Several of the leading 3D dental digital scanning systems are presented and discussed in this article.