Rapid Creation of a Multiagency Alternate Care Site for COVID-19- Positive Individuals Experiencing Homelessness.

Cook County Health partnered with the Chicago Departments of Public Health and Family & Support Services and several dozen community-based organizations to rapidly establish a temporary medical respite shelter during the spring 2020 COVID-19 peak for individuals experiencing homelessness in Chicago and Cook County, Illinois. This program provided low-barrier isolation housing to medically complex adults until their safe return to congregate settings. We describe strategies used by the health care agency, which is not a Health Resource and Services Administration Health Care for the Homeless grantee, to provide medical services and care coordination.

Service Learning in Health Care for Underserved Communities: University of Iowa Mobile Clinic, 2019.

The University of Iowa Mobile Clinic (UIMC) is an interdisciplinary student-run free medical clinic founded in 2002. UIMC provides free health screenings, education, and basic services to underserved populations in Iowa: immigrants, refugees, migrant farmworkers, individuals experiencing homelessness, low-income individuals, and people who live in rural communities. Forty-four percent of patients surveyed use UIMC as their only source of care. Ninety-seven percent of patients surveyed rate care as excellent or good. UIMC is a crucial safety net health care resource in Iowa to improve health equity.

An American Academy of Pediatrics State Chapter Initiative Advocating for Immigrant Children and Families.

The Illinois Chapter, American Academy of Pediatrics Refugee Immigrant Child Health Initiative (RICHI), a collaboration of physicians and child advocates, is one of the most robust state chapter programs of its kind. RICHI evolved by tapping into its key demographics to discern both patient needs and providers' skill sets. Although both may be unique to Illinois and its provider base, they can nonetheless provide a framework for creating and guiding state chapters to support the special needs of children in immigrant families. This article illustrates the importance of identifying and analyzing relevant local demographic and policy-related concerns and how to build capacity, connect to local resources, and form key partnerships. [Pediatr Ann. 2020;49(5):e228-e232.].

Crystal structure of pharmaceutical cocrystals of 2,6-diaminopyridine with piracetam and theophylline.

Pharmaceutical cocrystals are crystalline solids formed by an active pharmaceutical ingredient and a cocrystal former. The cocrystals 2,6-diaminopyridine (DAP)-piracetam [PIR; systematic name: 2-(2-oxopyrrolidin-1-yl)acetamide] (1/1), C5H7N3·C6H10N2O2, (I), and 2,6-diaminopyridine-theophylline (TEO; systematic name: 1,3-dimethyl-7H-purine-2,6-dione) (1/1), C5H7N3·C7H8N4O2, (II), were prepared by the solvent-assisted grinding method and were characterized by IR spectroscopy and powder X-ray diffraction. Cocrystal (I) crystallized in the orthorhombic space group Pbca and showed a 1:1 stoichiometry. The DAP and PIR molecules are linked by an N-H...O hydrogen-bond interaction. Self-assembly of PIR molecules forms a sheet of C(4) and C(7) chains. Cocrystal (II) crystallized in the monoclinic P21/c space group and also showed a 1:1 stoichiometry. The DAP and TEO molecules are connected by N-H...N and N-H...O hydrogen bonds, forming an R22(9) heterosynthon. A bidimensional supramolecular array is formed by interlinked DAP-TEO tetramers, producing a two-dimensional sheet.

Descriptive epidemiology of clubfoot in Peru: a clinic-based study.

congenital clubfoot is the most common birth defect of the musculoskeletal system and affects 1 in every 1000 live births each year.(1) Although there have been numerous studies of investigation, the etiology and pathogenesis of clubfoot remains unknown. To date, no epidemiological studies have been conducted in Peru to assess possible genetic and environmental risk factors associated with this deformity. The purpose of this study was to evaluate specific environmental and socioeconomic factors that may increase the risk of clubfoot. A descriptive clinic-based study was conducted using structured questionnaires given to biological mothers of clinically confirmed clubfoot patients (n=72) and biological mothers of children between ages 0-18 with no first or second degree family history of clubfoot as controls (n=103). Phenotypic data from clubfoot subjects were also collected. We found that males were twice as likely to have clubfoot as females, and half of all clubfoot patients had bilateral clubfoot. There was no significant difference in the rate of left vs. right clubfoot. Infant birth in the winter months correlated with an increased risk of clubfoot (p=0.01476). Maternal characteristics found to be significantly associated with increased risk of clubfoot were young maternal age at conception (p=0.04369) and low maternal education (p=0.003245). Young paternal age also had a correlation with increased risk of clubfoot in the child (p=0.0371). Both paternal smoking (p=0.00001) and the presence of any household smoking (p=0.00003) were strongly associated with an increased risk of clubfoot.

Barriers to the Ponseti method in Peru: a two-year follow-up.

Idiopathic clubfoot affects approximately 100,000 children each year and is one of the leading causes of disability worldwide. The Ponseti method is an inexpensive, non-surgical treatment that, when executed correctly, is more than 95% effective; however, in Peru, a developing country where a low-cost alternative is greatly needed, physicians report up to 30% of patients do not complete treatment. This study involved semi-structured interviews with 25 physicians who practice the Ponseti Method in Peru to discuss obstacles for the method in their country. The most frequent obstacles to the Ponseti method in Peru reported by physicians included lack of physicians trained in the Ponseti method in the country, patient transportation and distance to treatment centers, and lack of parental knowledge of the Ponseti method. These data suggest the need to train more physicians in Peru, particularly in the provinces. Increasing access to trained physicians in provincial areas may reduce the financial and travel burden of parents to help increase compliance with treatment.