Journal of general internal medicine
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Hospitalized incarcerated patients are commonly shackled throughout their duration of treatment in community medical centers to prevent escape or harm to others. In the absence of overarching policies guiding the shackling of non-pregnant, incarcerated patients, clinicians rarely unshackle patients during routine care. We provide a medical-legal lens through which to examine inpatient shackling, review the limited evidence supporting the practice, and highlight harms associated with shackling in the hospital. We conclude by offering guidance to advance evidence-based shackling practices that prevent physical harm, reduce prejudice towards incarcerated patients, and relinquish reliance on shackles in favor of tailored security measures.
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The Coronavirus Aid, Relief, and Economic Security (CARES) Act led to the rapid implementation of telemedicine across healthcare office settings. This innovation has the potential to improve healthcare use and ensure continuity of care. However, this delivery model could have an unintended consequence of worsening racial/ethnic disparities in healthcare utilization if adoption varies across sub-populations. ⋯ Racial/ethnic disparities in telemedicine use persisted among this cohort. However, telemedicine improved utilization for African Americans and Hispanics living farther away from the clinic.
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Randomized Controlled Trial
A Centralized Program with Stepped Support Increases Adherence to Colorectal Cancer Screening Over 9 Years: a Randomized Trial.
Screening over many years is required to optimize colorectal cancer (CRC) outcomes. ⋯ An outreach program that included mailed fecal tests and phone follow-up led to increased adherence to CRC testing and fewer age-eligible individuals without any CRC testing over 9 years.