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Biomedical subjects

M Shinn

Publications and source records attributed to M Shinn.

15 recordsLinked to original sources
PubMed1999

The relationship of residential instability to medical care utilization among poor mothers in New York City.

OBJECTIVES: This study examines the relationship between residential instability, including mobility and previous homelessness, and the use of medical care among previously sheltered and never-sheltered mothers in New York City. The study represents one of the first efforts to follow up on families after they are no longer homeless. METHODS: Mothers from 543 welfare families in New York City were interviewed, once in 1988 (Time 1) and again beginning in 1992 (Time 2). The sample included 251 families who first entered shelters after their 1988 interview, and 292 families who spent no time in shelters before or after that point. Mothers were asked about the source and volume of medical care used in the year before follow-up. RESULTS: Bivariate and multivariate analyses showed that previously sheltered mothers had a greater reliance on emergency departments (EDs) and weaker ties to private physicians or health maintenance organizations (HMOs) than did mothers who never used shelters. Mobility before the Time 1 interview was associated with greater reliance on EDs and absence of a usual source of care. More recent mobility was not associated with a usual source of care. Current residential stability reduced the likelihood of using an emergency department or having no regular source of care. None of the measures of residential instability were related to the volume of outpatient care used by mothers. CONCLUSIONS: A history of residential instability, particularly previous shelter use, strongly predicts where poor mothers currently seek health care. Further research is needed to determine whether these patterns of health care use existed before mothers entered shelters. The study provides evidence that upon leaving shelters, mothers are not being well integrated into primary care services.

Adult↗
PubMed1998

Predictors of homelessness among families in New York City: from shelter request to housing stability.

OBJECTIVES: This study examined predictors of entry into shelter and subsequent housing stability for a cohort of families receiving public assistance in New York City. METHODS: Interviews were conducted with 266 families as they requested shelter and with a comparison sample of 298 families selected at random from the welfare caseload. Respondents were reinterviewed 5 years later. Families with prior history of shelter use were excluded from the follow-up study. RESULTS: Demographic characteristics and housing conditions were the most important risk factors for shelter entry; enduring poverty and disruptive social experiences also contributed. Five years later, four fifths of sheltered families had their own apartment. Receipt of subsidized housing was the primary predictor of housing stability among formerly homeless families (odds ratio [OR] = 20.6, 95% confidence interval [CI] = 9.9, 42.9). CONCLUSIONS: Housing subsidies are critical to ending homelessness among families.

Adult↗
PubMed1997

In vivo role of glucocorticoids in barotrauma vascular repair and fibrosis.

To determine the important repair events leading to vascular collagen accumulation following barotrauma, in vivo changes were assessed during dexamethasone (DEX) treatment, as well as physiological healing. Hypercholesterolemic rabbits underwent bilateral iliac artery endothelial denudation, followed by angioplasty. Messenger ribonucleic acid (RNA) (procollagen types I, III and transforming growth factor [TGF]beta1), and bio-histometric composition of iliac arteries of animals treated with DEX (2, 7 and 7 days; 1 mg/kg1/day1), were compared to that in controls 2, 7 and 30 days after angioplasty. Type I and III procollagen mRNA transcripts were up-regulated following injury in either group. Similarly, TGFbeta1 mRNA levels were also elevated; however, treatment with DEX led to down-regulation at day 30 post-angioplasty. Linear regression and correlation of the densitometric ratios of procollagen alpha1(I) and TGFbeta1 mRNA during repair were observed significantly in either group (DEX-treated, r2= 0.84; non-treated, r2=0.79). Biochemically derived total vascular RNA concentration decreased transiently (7 days), with DEX-treatment (P = 0.003). Arterial lumen cross-sectional area was reduced between days 2 and 30 (P=<0.02), accompanied by an increase in fibrillar collagen concentration in both groups of animals post-angioplasty. These results suggest that during barotrauma repair, administration of DEX (approximately 1 week), does not affect vascular intimal hyperplasia or fibrosis, and that despite treatment, significant production of type I procollagen mRNA continues, influencing subsequent collagen deposition. The data also confirm a strong correlation between TGFbeta1 and type I procollagen mRNA expression, and modestly with type III procollagen during post-angioplasty repair.

Angioplasty↗
PubMed1997

Family homelessness: state or trait?

Compares conceptualizations of homelessness as a temporary state through which people pass or a permanent trait that emanates from individual characteristics. Evidence from a longitudinal study of 564 homeless families in New York City and additional secondary sources supports the view that for families, homelessness is a temporary state that is resolved by the provision of subsidized housing. Even for single individuals with severe mental disturbances, housing is a key factor in ending homelessness, although here there is more evidence that social services also contribute. Policy implications are that governments should take a more active role in reducing homelessness by providing access to subsidized housing.

Adult↗
PubMed1992

Homelessness: what is a psychologist to do?

Contrasts person-centered and structural explanations for homelessness. Methodological problems in studies of homeless people tend to exaggerate the role of individual deficits as causes of homelessness. A review of data on the distribution of poverty and of inadequate and unaffordable housing, with special emphasis on families, suggests the importance of structural causes. Data from 700 families requesting shelter and 524 families randomly drawn from the public assistance case load in New York City provide more support for a structural than for an individual deficit model. Individual demographic factors are also important. Implications are drawn for research and action by psychologists.

Ill-Housed Persons↗
PubMed1992

Predictors of shelter use among low-income families: psychiatric history, substance abuse, and victimization.

For poor housed and homeless families in New York City, NY, we examined the degree to which psychiatric and substance-abuse problems and victimization placed the families at elevated risk of requiring emergency housing, and we documented the prevalence of such problems. These problems were infrequently reported by both groups. However, past mental hospitalization, treatment in a detoxification center, childhood sexual abuse, and adult physical abuse were associated with increased risk of homelessness.

Adult↗
PubMed1991

The impact of homelessness on children.

This article reviews and critiques community-based research on the effects of homelessness on children. Homeless children confront serious threats to their ability to succeed and their future well-being. Of particular concern are health problems, hunger, poor nutrition, developmental delays, anxiety, depression, behavioral problems, and educational underachievement. Factors that may mediate the observed outcomes include inadequate shelter conditions, instability in residences and shelters, inadequate services, and barriers to accessing services that are available. Public policy initiatives are needed to meet the needs of homeless children.

Adolescent↗
PubMed1991

Social relationships and vulnerability to becoming homeless among poor families.

This study compares social relationships of 677 mothers in families requesting shelter with those of 495 mothers in housed families, randomly selected from the public assistance caseload in New York City. As hypothesized, women seeking shelter had experienced higher levels of a variety of childhood and adult events indicative of disruptions in social relationships. Contrary to our hypothesis, they were more likely than were housed mothers to have had recent contact with parents, other relatives, and friends, although they felt less able to draw on these resources for help with their current housing needs. More than three fourths of families seeking shelter had already stayed with members of their social network in the past year. The data suggest that they had used up potential sources of support before turning to public shelter.

Adult↗
PubMed1989

Crossing substantive domains.

This paper advocates a middle ground between detailed immersion in a single context and broad generalizations that ignore context. Contextual constraints are best understood when context is varied explicitly. For example, both the content and the effects of coping efforts and social support varied with context across several studies. Comparison across substantive domains is an important tool for understanding both theory and any specific domain.

Child Care↗
PubMed1987

Expanding community psychology's domain.

Community psychology's twin goals of prevention and empowerment are ill-served when researchers and practitioners restrict their activities to traditional mental health settings. This paper echoes the call of the Swampscott conference for expanding community psychology's domain of inquiry and action. It reviews examples from the research literature of efforts at prevention and empowerment in five classes of behavior settings identified by Barker (1968), namely, schools, work sites, religious settings, voluntary associations, and government, and suggests additional roles community psychologists might play.

Community Mental Health Services↗
PubMed1984

Coping with job stress and burnout in the human services.

A mail survey of 141 human service workers investigated the effects of coping on psychological strain and "burnout" produced by job stress. The survey assessed job stressors and coping strategies with open-ended questions and measured strain using closed-ended alienation, satisfaction, and symptom scales. Because previous research suggested that individual coping responses do not alleviate strain produced by job stress, the survey elicited information on group coping (social support) and on coping strategies initiated by agencies. Job stress was associated with high levels of strain, and group coping with low levels, but individual responses had little effect. Although workers identified many strategies that agencies could use to reduce stress and strain, actual use of such strategies was slight. Because men and women worked in the same jobs, no sex differences in individual coping were predicted and none were found; women, however, reported more social support than men. There was no evidence for moderating (interaction) effects of stress and coping on strain.

Adaptation, Psychological↗
PubMed1981

A content analysis of the data presented at special education placement team meetings.

Conducted two studies to ascertain the kinds of information presented and discussed at special education placement team meetings. Both studies used naturalistic observation methodologies. In study 1 it was demonstrated that teams spend twice as much time discussing academic information as time spent discussing behavioral information. Almost no time was spent discussing physical or medical data. In study 2 we looked at the specific kinds of assessment data presented and discussed. Nearly all of the meetings were devoted primarily to presentation and discussion of classroom data, scores on achievement tests, and scores on intelligence tests.

Achievement↗