Journal of urban health : bulletin of the New York Academy of Medicine
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Over the last 40 years, thousands of communities-in the United States and internationally-have been working to broaden the involvement of people and organizations in addressing community-level problems related to health and other areas. Yet, in spite of this experience, many communities are having substantial difficulty achieving their collaborative objective, and many funders of community partnerships and participation initiatives are looking for ways to get more out of their investment. One of the reasons we are in this predicament is that the practitioners and researchers who are interested in community collaboration come from a variety of contexts, initiatives, and academic disciplines, and few of them have integrated their work with experiences or literatures beyond their own domain. ⋯ Following a detailed explication of the model, the article focuses on the implications of the model for research, practice, and policy. It describes how the model can help researchers answer the fundamental effectiveness and "how-to" questions related to community collaboration. In addition, the article explores differences between the model and current practice, suggesting strategies that can help the participants in, and funders of, community collaborations strengthen their efforts.
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The prevalence of soft tissue infections (abscesses, cellulitides, infected ulcers) among injection drug users (IDUs) is estimated to be between 21% and 32%. Little is known regarding the health care utilization associated with these infections. This study describes IDUs seeking emergency department (ED) care for soft tissue infections, their inpatient health care utilization, including operating room procedures, and the types and locations of infections associated with increased inpatient health care utilization. ⋯ Among those with abscesses, deltoid abscesses were 5.2 times more likely to receive an operating room procedure compared to other abscess locations. IDUs with cellulitis and deltoid abscesses commonly required inpatient care and operating room procedures. The morbidity associated with such infections and the intensive use of hospital services needed to treat these infections provide strong rationale for the development of preventive interventions and improved care for this neglected clinical problem.
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In North America, street youths are generally considered at very high risk of injection drug use. To estimate the incidence rate of injection drug use in this population and to identify predictors of injection drug use, we conducted the present analysis. Among participants to a cohort study initiated in January 1995, we selected subjects who had never injected at study entry and had completed at least one follow-up questionnaire. ⋯ Among the 415 never injectors (mean age at entry 19.5 years), 74 had initiated injection by January 2000 (incidence rate 8.2 per 100 person-years). Independent predictors of initiation were recent episode of homelessness; age younger than 18 years; being tattooed; recently using hallucinogens, heroin, and cocaine/crack/freebase; having a friend who injects drugs; and having ever experienced extrafamilial sexual abuse. This study showed that injection drug use is frequent among street youths, but prevention appears possible.
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Comment Letter Comparative Study
Re: "Named reporting and mandatory partner notification in New York State: the effect on consent for perinatal HIV testing".