Population Prevalence Rates Research Articles

Obesity diagnoses in children and adolescents in Norway by immigrant background.

Relatively few obese children and adolescents receive specialist treatment. Our aim was to assess associations between risk of receiving an obesity diagnosis in secondary/tertiary health services by socio-economic position and immigrant background in order ultimately to improve equity in health services. The study population comprised Norwegian-born children aged 2-18 years between 2008 and 2018 (N=1,414,623), identified via the Medical Birth Registry. Cox regressions were used to calculate hazard ratios (HR) of an obesity diagnosis from secondary/tertiary health services (Norwegian Patient Registry) by parental education and household income and by immigrant background. Higher parental education and household income were associated with a lower hazard of obesity diagnosis regardless of Norwegian versus immigrant background. Compared to having a Norwegian background, having a Latin American (HR=4.12; 95% confidence interval (CI) 3.18-5.34), African (HR=1.54; 95% CI 1.34-1.76) and Asian (HR=1.60; 95% CI 1.48-1.74) background was associated with higher hazard of obesity diagnosis. Adjusted for parental education and household income, corresponding HRs were 3.28 (95% CI 2.95-3.65) for Latin America, 0.95 (95% CI 0.90-1.01) for Africa and 1.08 (95% CI 1.04-1.11) for Asia. Within Asia, those with a background from Pakistan, Turkey, Iraq and Iran had higher hazards than those with a Norwegian background, while those with a background from Vietnam had lower hazards, even after adjusting for parental education and household income. To ensure more equitable treatment, more knowledge is warranted about health-service access and referral patterns, and underlying population prevalence rates, for obese children and adolescents with different immigrant backgrounds.

Autism spectrum disorder and genetic: a possible correlation?

IntroductionAutism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social interaction and communication, whose etiology is heterogeneous, including genetic, epigenetic, and environmental factors. It is associated with restricted interests and stereotyped behaviors with high prevalence rates in general population, neurobiological bases and high heritability.ObjectivesThe aim of our study is to identify the possible phenotype-genotype relationships regarding neurodevelopmental disorders and to evaluate a correlation between genomic alterations and the manifestations of the overt and subthreshold ASD in a family administered psychiatric clinical evaluations at our hospital.MethodsThe family M underwent a psychiatric evaluation through the MINI interview according to the SCID-5 criteria, the AQ, ADAS, PAS-SR, SHI-SHY,SHY-OBS to assess respectively the subthreshold traits of ASD in adulthood, the panic-agoraphobic, social-phobic and obsessive-compulsive spectrum and CAT-Q Italian version, to evaluate social camouflage behaviors typical of ASD individuals. Array Comparative Genomic Hybridization was used for studying DNA imbalances in this family.ResultsWe found that Mrs.A, her father, her brothers and her older sister had a microduplication, very likely pathogenic, since it has been never reported in healthy subjects and harbors several genes. It could be related with overt and subthreshold traits of ASD. From the questionnaires administered and from the clinical interview, it emerged that Mrs.A is affected by ASD and Bipolar Disorder. Her twin brothers have been evaluated at early ages by child neuropsychiatric clinic and they were diagnosed with ASD and mental and psychomotor impairment. Her father was reported a significant trend in ADAS, AQ, PAS-SR, SHI-SHY and SHY-OBS scores. Finally, about her older sister, even if our results were not significant for an ASD diagnosis, we speculated that she performed a high score in some ADAS items and in the CAT-Q but not in the AQ. Females generally tend to attract fewer attention than males thanks to their better coping and camouflaging mechanisms as well as their ability to “disappear” in large groups.ConclusionsGenetic knowledge can have a relevant clinical impact; a genetic etiology can be identified in individuals with ASD, leading to the identification of treatable psychiatric comorbidities. Furthermore, knowing the causative genetic variants of ASD could provide crucial information for genetic counseling as well as to understand the neurobiology of these disorders and to contribute to an early diagnosis.Disclosure of InterestNone Declared

MODERN METHODS OF ROSACEA TREATMENT

Rosacea is a chronic inflammatory dermatosis that mainly affects the cheeks, nose, chin and forehead. Rosacea usually begins between the ages of 30 and 50, but can occur at any age. Population prevalence rates range from < 1 to 22%, but these percentages are likely influenced by differences in study design, methodology, population, geographic location, and cultural and social differences. Rosacea is characterized by recurrent episodes of flushing or transient erythema, persistent erythema, phymatous changes, papules, pustules, and telangiectasia, and the eyes may be involved. Due to the fact that rosacea affects the face, patients with this pathology often have low self-esteem and are prone to anxiety and depression, because this disease has a cosmetic defect. In addition to general skin care, there are several approved treatment options available to address these issues, both topical and systemic. For some functions, intense pulsed light, laser, and surgery are valuable. Recent advances in basic science have highlighted the role of the innate and adaptive immune system, as well as neurovascular dysregulation, underlying the spectrum of clinical manifestations of rosacea. Endogenous and exogenous stimuli can initiate and exacerbate multiple pathways in patients with rosacea.
 With the updated diagnosis and classification of rosacea, treatment options for patients with rosacea have attracted the attention of dermatologists. Here, we summarize the latest advances in the treatment of rosacea, including skin care and cosmetic procedures, topical therapy, oral therapy, laser and light therapy, injection therapy, and combination therapy.

Prevalence of familial autoimmune diseases in juvenile idiopathic arthritis: results from the international Pharmachild registry

BackgroundLittle is known about the disposition to autoimmune diseases (ADs) among children diagnosed with JIA. In this study, we provide a comprehensive overview of the prevalence of and factors associated with ADs in parents of children with juvenile idiopathic arthritis (JIA).MethodsPrevalence rates of ADs and 95% Poisson confidence intervals were calculated for parents of JIA patients from the international Pharmachild registry and compared with general population prevalence rates as reported in the literature. Demographic, clinical and laboratory features were compared between JIA patients with and without a family history of AD using χ2 and Mann-Whitney U tests.ResultsEight thousand six hundred seventy three patients were included and the most common familial ADs were psoriasis, autoimmune thyroid disease, rheumatoid arthritis and ankylosing spondylitis. The prevalence of several ADs was higher in parents of the included JIA patients than in the general population. Clinical Juvenile Arthritis Disease Activity Scores at study entry and last follow-up were not significantly different between patients with (n = 1231) and without a family history of AD (n = 7442). Factors associated with familial AD were older age at JIA onset (P < 0.01), Scandinavian residence (P < 0.01), enthesitis-related arthritis, psoriatic arthritis and undifferentiated arthritis (P < 0.01), ANA positivity (P = 0.03) and HLA-B27 positivity (P < 0.01).ConclusionsFamilial AD proves to be a risk factor for JIA development and certain diseases should therefore not be overlooked during family health history at the diagnosis stage. A family history of AD is associated with the JIA category but does not influence the severity or disease course.

Pancreatic Enzyme Replacement Therapy in Patients with Non-pancreatic Digestive Conditions: A Nationwide Claims Analysis.

Pancreatic enzyme replacement therapy (PERT) is most commonly used to treat exocrine insufficiency related to pancreatic diseases, but can be used for non-pancreatic digestive conditions (NPDC). We aimed to determine the prevalence of PERT use and describe prescription patterns in individuals with NPDC. A nationally representative claims database of 48.6 million enrollees was used to identify individuals who received PERT prescription(s) in the absence of any pancreas-related diagnosis. Data on demographics, enrolment, comorbidities, exocrine function testing, treatment and potential indications for PERT were retrieved, and compared with individuals who received PERT for primary diagnosis of chronic pancreatitis (CP). A total of 29,234 individuals (64.1% female, mean age 52.4 ± 16.5years) received PERT for NPDC. The overall estimated US population prevalence rate for PERT use for NDPC was 60.2/100,000 persons. Rates increased significantly with age and were higher in women in all age groups except 1-20years old. When compared with CP, individuals with NPDC receiving PERT were more likely to be older (52.4 vs. 50.1years), female (64.1% vs. 51.0%), have lower prevalence of alcoholism (3.6% vs. 25.0%), tobacco abuse (8.4% vs. 30.1%), and received PERT for shorter mean duration (5.3 vs. 8.2months) (all p < 0.001). Median dose of PERT in individuals with NPDC was 2880 lipase units/day. Although proportionally low, a sizable population receives PERT for NPDC. PERT for NPDC is usually prescribed at a low dose and for shorter duration, suggesting it is used mostly as a trial for or until resolution of symptoms.

The relationship between eating disorders and OCD symptom dimensions: An explorative study in a large sample of patients with OCD

ObjectivesThis study aimed to describe lifetime and current rates of occurrence of comorbid eating disorders (ED) in a large clinical OCD sample, and to investigate whether comorbid ED in OCD (OCD+ED) are associated with specific demographic, somatic or clinical characteristics. MethodData were obtained from the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. A sample of 419 participants with lifetime OCD was evaluated on co-occurrence with ED. ResultsLifetime comorbidity with ED occurred in 44 patients (10.5% of the sample), a frequency that exceeds prevalence rates in the normal population. Patients with OCD+ED were on average overweight compared to OCD-ED. The OCD+ED group reported more aggression and checking symptoms and had a younger age of onset of OCD. Further, more comorbidity with MDD, social phobia, PTSD, and depression and anxiety symptoms was reported. ConclusionPatients with OCD+ED seem to clinically represent a sub-group of OCD with more severe psychopathology, and specifically with trauma-related factors and comorbid anxiety and depressive symptoms. Future studies using a longitudinal design should focus on whether patients with OCD+ED differ regarding course characteristics from patients with OCD-ED. Finally, comorbidity with depression, social anxiety and trauma should be taken into account in treatment of patients with OCD+ED.

The future of CBT and evidence-based psychotherapies is promising.

The future of CBT and evidence-based psychotherapies is promising.

An assessment of prevalence of Type 1 CFI rare variants in European AMD, and why lack of broader genetic data hinders development of new treatments and healthcare access.

Advanced age-related macular degeneration (AAMD) risk is associated with rare complement Factor I (FI) genetic variants associated with low FI protein levels (termed 'Type 1'), but it is unclear how variant prevalences differ between AMD patients from different ethnicities. Collective prevalence of Type 1 CFI rare variant genotypes were examined in four European AAMD datasets. Collective minor allele frequencies (MAFs) were sourced from the natural history study SCOPE, the UK Biobank, the International AMD Genomics Consortium (IAMDGC), and the Finnish Biobank Cooperative (FINBB), and compared to paired control MAFs or background population prevalence rates from the Genome Aggregation Database (gnomAD). Due to a lack of available genetic data in non-European AAMD, power calculations were undertaken to estimate the AAMD population sizes required to identify statistically significant association between Type 1 CFI rare variants and disease risk in different ethnicities, using gnomAD populations as controls. Type 1 CFI rare variants were enriched in all European AAMD cohorts, with odds ratios (ORs) ranging between 3.1 and 7.8, and a greater enrichment was observed in dry AMD from FINBB (OR 8.9, 95% CI 1.49-53.31). The lack of available non-European AAMD datasets prevented us exploring this relationship more globally, however a statistical association may be detectable by future sequencing studies that sample approximately 2,000 AAMD individuals from Ashkenazi Jewish and Latino/Admixed American ethnicities. The relationship between Type 1 CFI rare variants increasing odds of AAMD are well established in Europeans, however the lack of broader genetic data in AAMD has adverse implications for clinical development and future commercialisation strategies of targeted FI therapies in AAMD. These findings emphasise the importance of generating more diverse genetic data in AAMD to improve equity of access to new treatments and address the bias in health care.

Estimating the quantity of smokeless tobacco consumption among older adults in India

Problem consideredGlobally, smokeless tobacco (SLT) users are highest in India. Whilst, studies examined prevalence and determinants of SLT use, no evidence exists which examined the quantity of SLT consumed. MethodsStudy utilized national representative data from the Longitudinal Aging Study in India (LASI) which adopted a multistage stratified area probability cluster sampling design. First, we computed the average SLT consumption per day (in grams) from the LASI data. Consecutively, we further utilized the projected population approximations from the 26th round of the official United Nations population estimates and prevalence rate of current SLT use from the Global Adult Tobacco Survey (GATS-2) and LASI Survey, separately to estimate SLT use pattern for the entire Indian population aged 45 or above. ResultsThe prevalence of current SLT use among older adults was 17.2% wherein the SLT use is higher among men (20.8%). On average, an older adult consumes 1.01 g of SLT on a daily basis. The range of SLT quantity consumed by users’ according to the LASI and GATS-2 prevalence, varies from 65,000 kg to 85,000 kg per day whereas, annual consumption ranges from 23 million kilograms to 32 million kilograms, respectively. ConclusionThe development of SLT cessation services examining the quantitative aspects of SLT use would be beneficial in tackling the high SLT burden in India and improving the rates of intention to quit.

HISTOPATHOLOGICAL ANALYSIS OF COLORECTAL CANCER SPECIMENS IN A TERTIARY HOSPITAL IN PUDUCHERRY: A PROSPECTIVE STUDY

Objective: According to GLOBOCAN 2020, colorectal cancer is the fourth most lethal cancer in infected patients worldwide, with 1.7 million new cases recorded each year. When we look at Indian population studies, their mortality, incidence, and prevalence rates are consistently increasing compared to other European countries. Only a few studies have been reported on the clinical profile of CRC in India. Compared to females, males are more affected. This study was carried out to study the age, sex, and size distribution of malignant colon cancer and correlate the histopathological spectrum of colonic biopsies with clinical findings. Methods: Our study was a unicenter-based prospective study carried out over 2 years. All colonoscopic biopsies have been received in the Department of pathology, Aarupadai Medical College, and Hospital. Colonoscopies biopsies and colonic resection specimens are routinely fixed with 10% formalin and processed through an automatic tissue processor. Further, slides were stained with hematoxylin and eosin stains and examined for microscopic examination. Data generated from microscope observation were used for statistical analysis. Results: Our study included 54 patients with colorectal cancer. Among the patients, males were outnumbered by female patients, having an M: F ratio of 1:7:1. The most common age group affected is between the ages of 61 and 70. Adenocarcinoma was the most common histological malignancy (83%), followed by mucinous adenocarcinoma (7%), neuroendocrine carcinoma (4%), signet ring cell carcinoma (4%), and malignant melanoma (2%). Conclusion: Histopathological evaluation is the gold standard for the early detection of the gastrointestinal tract diseases, especially malignant diseases, which helps in the early prevention measures. Further, detailed studies on immunohistochemistry and molecular studies on colonoscopy biopsy specimens should be done in constant correlation with clinical features to help early detection of CRC and therapeutic prognostic purposes.

Diagnostic accuracy of SARS-CoV-2 Panbio™ rapid antigen diagnostic tests in a 4,440-case clinical follow-up.

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Rapid Antigen Detection Testing (RADT) has been subjected to several evaluations in reference to diagnostic accuracy, ranging from small scale up to large population studies including nation-wide community-based studies. All confirmed the diagnostic accuracy of the tests which were strongly dependent upon the infection's population prevalence. In our retrospective study, parallel SARS-CoV-2 Panbio™ RADT assay, including real-time reverse transcription quantitative polymerase chain reaction (RT-qPCR) tests, were aimed to evaluate diagnostic performance regarding the rapid antigen diagnostic testing. Out of 4,440 paired tests, 609 samples tested positive using RT-qPCR, resulting in a prevalence of 13.7%. Panbio detected 251 (5.7%) positive tested samples. Overall sensitivity was 41.2% (95% CI 37.4–45.2%) and overall specificity was 99.7% (95% CI 99.4–99.8%). Positive predictive value (PPV) was 95.1% (95% CI 91.8–97.1%) and the negative predictive value (NPV) was 91.4% (95% CI 90.5–92.2%). RADT sensitivity increased with stratification in reference to the results according to PCR Cycle threshold (Ct) and presence of the symptoms considerably influenced PPV and NPV. Sensitivity in the group of Ct values ≤ 20 was 91.2%, 68.6% within the Ct range of 20–25, 47.9% in the group of Ct values between 25 and 30, and 12.6% in the group of Ct values between 30 and 35. A follow-up of the positive cases aligned with RT-qPCR testing and comparison of the general population enrolled in the testing in which the fatal cases occurred enabled us to estimate real clinical diagnostic performance regarding the SARS-CoV-2 Panbio RADT. Based upon our results, we recommend the SARS-CoV-2 Panbio RADT tests be carried out as the primary test, without parallel PCR testing, only among high population prevalence rates of the infection and to be used for symptomatic individuals with average or low severe disease developmental risk. In the case of high risk regarding the development of severe infection complications, a parallel SARS-CoV-2 RT-qPCR is needed to be carried out to attain proper diagnostic accuracy and avoid delaying appropriate medical care.

Self-reporting of psychiatric illness in an online patient registry is a good indicator of the existence of psychiatric illness

Online registries offer many advantages for research, including the ability to efficiently assess large numbers of individuals and identify potential participants for clinical trials and genetic studies. Of particular interest is the validity and utility of self-endorsement of psychiatric disorders in online registries, which, while increasingly more common, remain understudied. We thus assessed the comparability of prevalence estimated from self-endorsement of psychiatric disorders in one such registry, the Brain Health Registry (BHR) to prevalence computed from large US-based epidemiological studies and the degree to which BHR participants report psychiatric disorders consistently. We also examined the concordance between self-report and clinically determined diagnoses of various DSM-5 psychiatric disorders in a subset of participants who underwent direct assessments and identified possible reasons for discordance.Rates of self-reported psychiatric disorders were closest to previously reported population prevalence rates when endorsed at multiple timepoints, and accuracy was at least 70% for all except Hoarding Disorder as compared to the clinical diagnoses. Clinical data suggested that self-endorsement of a given psychiatric diagnosis was indicative of the presence of a closely related condition, although not necessarily for the specific disorder, with the exception of major depressive disorder, panic disorder, and hoarding disorder, which had high positive predictive values (85%, 73%, 100%, respectively).We conclude that self-reporting of psychiatric conditions in an online setting is a fair indicator of psychopathology, but should be accompanied by more in-depth interviews if using data from a participant for a specific disorder.

Mental Illness as a Vulnerability for Sexual Assault: A Retrospective Study of 7,455 Sexual Assault Forensic Medical Examinations.

ABSTRACTBackgroundPersons with severe mental illness (MI) are at a high risk of becoming victims of sexual assault (SA). Vulnerability for SA with any type of MI is unknown. This study aimed to identify the prevalence of preexisting MI and other significant factors in patients reporting preexisting MI at the time of their SA medical forensic examinations (SAMFEs).MethodA retrospective SAMFE chart review of patients (N = 7,455) from 2010 to 2020 was conducted. Sexual assault nurse examiners completed SAMFEs. Inclusion criteria included (a) aged 14 years and older, (b) completed SAMFE with SA kit evidence collection, and (c) reported to law enforcement (restricted cases not included). Descriptive statistics and chi-square analyses were completed.FindingsIt was found that 46.7% of study participants reported preexisting MI and/or current use of psychotropic medications, more than double the MI prevalence rates in the general population. MI in patients seen for SAMFE was associated with prior history of SA, medical health problems, and physical or mental impairment. In addition, patients with MI reported more violent SAs with increased anogenital and nonanogenital injuries.DiscussionThe high prevalence rate of any MI in patients seen for SAMFE indicates MI in varying severity is a significant vulnerability for SA. The association of preexisting MI with a history of SA, health problems, and physical or mental impairment expands understanding of associated MI factors. These findings support the development of interventions by healthcare providers and stakeholders to address SA vulnerabilities in individuals with MI.

Morbidity of the working-age population of the Russian Federation for 2015–2019

Introduction. The quality of labour potential is one of the most important factors of economic growth, which largely depends on the health status of the working-age population. Today, incidence and prevalence rates in the Russian working-age population are not monitored at the national level. Materials and methods. We conducted a descriptive epidemiological study based on retrospective data on disease incidence in the adult population of the Russian Federation. We also assessed disease incidence and prevalence in the Russian working-age population (men aged 18-59 and women aged 18-54) in 2015-2019 using the method of continuous observation. We estimated and ranked incidence and prevalence rates per 100,000 working-age population of some constituent entities and federal districts of the Russian Federation to establish the territories with the highest and lowest rates. Results. We applied and tested methodological approaches to assessing the morbidity of the working-age population living in different regions of the Russian Federation. Our findings demonstrate a high degree of variability in both incidence and prevalence rates in the working-age population in general and by ICD-10 disease categories. Conclusion. Results of our assessments and ranking of the constituent entities of the Russian Federation by disease-specific incidence and prevalence rates in the working-age population provide an opportunity to areas at risk with specific health status enabling the most efficient management of risks of labour and economic losses. The proven method approaches may be used to address the challenges of public health monitoring.

Modeling Qualitative Outcomes by Supplementing Participant Data with General Population Data: A New and More Versatile Approach

Abstract Although one often has detailed information about participants in a program, the lack of comparable information on non-participants precludes standard qualitative choice estimation. This challenge can be overcome by incorporating a supplementary sample of covariate values from the general population. This paper presents new estimators based on this sampling strategy, which perform comparably to the best existing supplementary sampling estimators. The key advantage of the new estimators is that they readily incorporate sample weights, so that they can be applied to Census surveys and other supplementary data sources that have been generated using complex sample designs. This substantially widens the range of problems that can be addressed under a supplementary sampling estimation framework. The potential for improving precision by incorporating imperfect knowledge of the population prevalence rate is also explored.

Type 1 diabetes prevalence and incidence rates in the pediatric population of Veneto Region (Italy) in 2015–2020

The prevalence of Type 1 Diabetes (T1D) in the Veneto Region (Italy) in the 2015–2020 years was 152.5/100,000 subjects and the incidence 19.7/100,000 person-years. Accordingly, Veneto Region can be defined as a high-risk area for pediatric T1D.

Exploring COVID-19 Case Fatality in Relation to the Prevalence of Chronic Conditions and Health Behaviors in Appalachian Kentucky.

BackgroundResearch has demonstrated that common chronic conditions, especially those related to cardiovascular health, are important risk factors for severe COVID-19 symptoms or hospitalization. Population prevalence rates of such conditions have not previously been examined in relation to COVID-19 case fatality rates in the Central Appalachian region.PurposeThis study examined prevalence rates of selected chronic conditions and COVID-19 case fatality rates to determine whether the relationship between them is consistent across Appalachian and non-Appalachian regions of Kentucky.MethodsData from Kentucky’s Behavioral Risk Factor Survey (KyBRFS) were used to calculate prevalence rates of asthma, diabetes, influenza vaccination, hypertension, obesity, having a personal doctor, physical inactivity, and cigarette smoking. Publicly available COVID-19 case and death counts by county were used to calculate incidence and case fatality rates. Units of analysis were 41 single- and multi-county areas developed to visualize KyBRFS prevalence rates. Analysis included t-tests to compare Appalachian and non-Appalachian regions, and correlations characterizing associations between COVID-19 case fatality and rates of chronic conditions and behaviors.ResultsIncidence and case fatality rates for COVID-19 were slightly lower in the Appalachian region, but not significantly. Significant correlations between COVID-19 case fatality and the prevalence of chronic conditions and behaviors were more common in the non-Appalachian region.ImplicationsCase fatality rates in Appalachia appear lower than expected, given the high prevalence of important chronic conditions and behaviors known to be associated with poor COVID-19 outcomes. This phenomenon merits further research and should be considered by public health researchers when examining COVID-19 outcomes in Kentucky and neighboring states.

Diagnosis and Management of Cerebral Venous Sinus Thrombosis With Vaccine-Induced Immune Thrombotic Thrombocytopenia.

Diagnosis and Management of Cerebral Venous Sinus Thrombosis With Vaccine-Induced Immune Thrombotic Thrombocytopenia.

Systematic review and meta-analysis of the prevalence of depressive symptoms, dysthymia and major depressive disorders among homeless people

ObjectivesTo assess the global prevalence estimates of depressive symptoms, dysthymia and major depressive disorders (MDDs) among homeless people.DesignSystematic review and meta-analysis.Data sourcesDatabases including PubMed, Scopus and Web of Science were...

Mental Illness and Mental Health Care Treatment among People with Criminal Justice Involvement in the United States.

This study analyzes the effect of arrest and community supervision on mental health and mental health care using a U.S.-based nationally representative data from National Survey of Drug Use and Health (NSDUH) and Behavioral Model for Vulnerable Populations. It conducts a bivariate analysis to estimate population prevalence rates and generalized structural equation modeling (GSEM) to test the conceptual model. Individuals who were recently arrested or under community supervision (probation/parole) are more likely to use treatment (medication, inpatient, and outpatient care) for mental health problems compared with those with no CJ contact. However, there still remains a large unmet need. Overall, people with mental illness may be accessing mental health treatment through their involvement with the CJ system more broadly. There is the need for multiple societal institutions to work in tandem and communicate with vulnerable individuals who experience CJ contact to further assess appropriate assistance and mental health treatment.