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PURPOSE: The purpose of this study was to assess prostate-specific antigen (PSA) testing rates in persons experiencing homelessness (PEH), identify factors associated with screening, and compare PSA screening rates in PEH with a matched cohort of persons not experiencing homelessness (non-PEH). MATERIALS AND METHODS: We identified 9,249 potentially eligible PEH cared for at a large metropolitan hospital system from an institutional registry of all patients who presented to the health care system as homeless from 2014 to 2021. Homelessness was defined by the presence of the Z-code for homelessness (Z59), the listed address matching to the address of a homeless shelter or other transitional housing or a positive screen for homelessness. A matched cohort of 10,000 non-PEH was generated for comparison. Univariate chi-square analysis and multivariate logistic regression were performed to evaluate variables associated with PSA testing. RESULTS: A total of 1,605 PEH and 3,413 non-PEH were eligible for PSA screening within the study timeframe. Half of PEH were Black (50%). Medicaid was the most common insurance (51%), followed by Medicare (18%). PEH were less likely to have a PCP (58% v 81%, P < .001) and had a significantly lower PSA testing rate (13% v 34%, P < .001) compared with non-PEH. Univariate analysis revealed that PSA testing was more common in PEH who were employed ( P < .001), had private insurance or Medicare ( P < .001), or had an established primary care provider (PCP; P < .001). Multivariate analysis confirmed that having a PCP (OR, 2.54; 95% CI, 1.62 to 4.00; P < .001) significantly increased the likelihood of PSA testing in PEH. CONCLUSION: PEH experience low rates of prostate cancer screening. Interventions to increase screening in this population, including increased PCP access, are needed.

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Conclusion: Nurse participation in ED HCV screening within a single practice environment varies highly between individuals. This challenges the assertion that insufficient resources, including provider time, are the primary reason that ED providers cannot participate in screening programs. Improved understanding of individual provider-level reasons for non-participation is essential to optimize implementation of screening and prevention programs in EDs.

Any survivor among the millions of patients admitted to the intensive care unit (ICU) for critical illness each year is susceptible to persistent health problems that continue after discharge and may lead to post-intensive care syndrome (PICS), defi ned as new or worsening dysfunction from physical impairment, cognitive impairment, or emotional impairment, or a combination. Considering the increased rates of ICU survival and the growing elderly population more likely to utilize ICU resources, critical care practitioners have broadened their focus on outcomes and care of ICU survivors to include the acute post-ICU survival period as well as months and even years after ICU discharge. This review focuses on the neuropsychiatric aspects of PICS in ICU survivors including diagnostic, screening, and treatment recommendations. It also highlights the value of post-ICU clinics and the unique role of the consultation psychiatrist in the care of this patient population.

Most Americans perceive lysergic acid diethylamide (LSD) to be a high-risk drug, despite infrequent serious adverse events associated with its use. Though LSD use is rising in the United States, little is known about whether perceived risk of LSD (prLSD) is changing or factors influencing prLSD. Using National Survey on Drug Use and Health data from 2015–2019, we investigated correlates of and temporal trends in prLSD. On multivariable modeling for respondents 18 years of age and older, lower prLSD was associated with, among other factors, later survey year, personal LSD use, younger age, higher education level, male gender, identifying as a sexual minority, having less self-influential religious beliefs, and past year psychological distress. Higher prLSD was associated with identifying as Black or Hispanic, past year suicide attempt, and having children in the home. From 2015–2019, there was a statistically significant linear decreasing trend in proportion of respondents who perceived “great” risk in trying LSD [from 70.5–64.8%; (p < 0.0001)]. Our findings regarding prLSD and race/ethnicity could have important implications for acceptability of psychedelic therapy by Black and Hispanic patients. While we observed multiple important differences in prLSD among subgroups, overall prLSD amongst Americans may be falling to a level more accurately reflecting LSD’s actual risk profile.