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PubMed1990

The homeless.

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Ill-Housed Persons↗
PubMed2006

The meaning of living with dementia and disturbing behaviour as narrated by three persons admitted to a residential home.

AIM: The aim of our study was to illuminate the meaning of living with dementia and disturbing behaviour, as narrated by three persons admitted to a residential home. BACKGROUND: Living with dementia and so-called disturbing behaviour in an institution involves interaction with care providers and fellow residents and poses a challenge to all who are involved. METHODS: We asked the head nurses at a residential home to select persons with dementia and disturbing behaviour who were willing to be interviewed and able to communicate verbally. We performed 10 informal conversational interviews with three persons. The interviews were transcribed into text and interpreted using a phenomenological hermeneutic method inspired by Ricoeur's philosophy. RESULTS: The findings indicate that the meaning of living with dementia and disturbing behaviour, as narrated by three persons admitted to a residential home, is about being surrounded by disorder, being trapped by restriction and being set aside, as well as about being included. The findings are interpreted as a collapse of relations to self and others intertwined with occasional episodes of togetherness. This is reflected on in relation to the literature on homelessness and at-homeness and loss and maintenance of personal and social selves. RELEVANCE TO CLINICAL PRACTICE: The view others have of the person with dementia and of disturbing behaviour determines the nursing care given. Taking the residents' personal history and actual context into account, disturbing behaviour may be seen as a way persons with dementia express their story and maintain their self.

Dementia↗
PubMedDate not supplied

[Reasons for the hospitalization and length of stay of a homeless population in Montreal].

OBJECTIVE: To compare the hospitalization experience of a homeless population with that of the residents of a low socioeconomic area. METHODS: The homeless hospitalization records (n = 245) were compared with the records of the 3,553 residents of the Département de Santé Communautaire of Saint-Luc Hospital territory who were admitted to the same hospital. RESULTS: The homeless population is mainly composed of young men. Mental health diagnoses are more frequent while cardiovascular and the obstetrical diagnoses are more rarely seen. Homelessness is associated with an 11.2 increased risk of organic psychosis, a 6.1 risk increase of functional psychosis and a 3.8 risk increase of personality disorders, neurosis and substance abuse. Obstetrical diagnoses are 20 times less frequent among homeless women while the cardiovascular risk did not seem to be affected in our sample. The lengths of stay are similar.

Adolescent↗
PubMed1990

Homeless and housed families in Los Angeles: a study comparing demographic, economic, and family function characteristics.

We studied 196 homeless and 194 housed poor families in Los Angeles, California to gain an understanding of events that precipitate family homelessness. Both homeless and housed poor mothers averaged 29 years old and were accompanied by two or three children. Three-fourths of both the homeless and housed families had income below the poverty level, and both groups expended almost two-thirds of their income on housing. Mothers in homeless families more commonly reported spousal abuse (35 vs 16 percent), child abuse (28 vs 10 percent), drug use (43 vs. 30 percent), or mental health problems (14 vs 6 percent) and weaker support networks. Homeless mothers more commonly came from homes where their parents abused drugs or alcohol (49 vs 34 percent) or more commonly lived outside the home or in foster care (35 vs 25 percent). Homelessness was reported as due primarily to economic pressures of housing costs, but personal and family problems frequently played a contributing role, especially for single parent families. Burdens of increasing housing costs and family dysfunction among housed poor families place many at risk for homelessness.

Adult↗
PubMed1991

Tuberculosis: a disease of the 1990s.

In the United States, the decades preceding the 1980s were characterized by a decline in the incidence of tuberculosis. More recently, the trend has undergone a significant reversal: Case rates have been increasing by 3% to 6% annually. In 1990, more than 25,700 cases were reported to the Centers for Disease Control. In a sense, tuberculosis is adapting to the '90s. The recent increase in its incidence tends to affect populations with identifiable characteristics. Among the most important of these groups are the populations at high risk for infection by the human immunodeficiency virus. The increase is also fueled by cases in populations that are medically underserved, including foreign-born persons from high-prevalence countries, persons with low incomes, and persons living in long-term-care facilities--especially persons with previous tuberculosis infection. Thus, factors such as homelessness, chronic alcohol or drug abuse, malnutrition, and crowded living conditions continue to favor development and transmission of disease. The increase in the incidence of tuberculosis appears to be greatest when subpopulations in such circumstances are also at high risk for HIV infection. Complex issues in the diagnosis and treatment of tuberculosis arise from these epidemiologic patterns. HIV infection is associated with unusual presentations of tuberculosis. Thus, the clinician must maintain a high index of suspicion for the disease in the setting of HIV infection or risk of the infection. The populations at greatest risk are likely to be mistrustful of the medical system, making the long-term administration of potentially toxic chemotherapy more difficult than it already is. Chronic substance abuse may complicate compliance and add further difficulties to the monitoring of chemotherapy. At the same time, the monitoring becomes even more important in the physician's effort to minimize adverse effects of the medications. Outbreaks of drug-resistant disease have recently occurred, complicating the selection of drugs and affecting the duration of treatment. Despite all of these problems, it is essential to establish a diagnosis and initiate treatment rapidly, both to arrest the disease process and to limit its transmission. Since Mycobacterium tuberculosis is spread to uninfected persons in aerosols generated by coughing or sneezing, the infectiousness of a patient with active disease can be related, at least in part, to the number of organisms seen on sputum smears. Initiation of therapy is followed by a rapid decline in infectivity.

Acquired Immunodeficiency Syndrome↗
PubMed1997

The relationship of public support payments to substance abuse among homeless veterans with mental illness.

OBJECTIVE: A suspicion that disability payments may exacerbate substance use among persons with chemical addictions recently led Congress to limit federal disability entitlements of applicants whose disability status is related to substance abuse, even if they have another serious mental disorder. This study empirically explored the relationship between receipt of disability payments and substance use among homeless mentally ill veterans. METHODS: The study sample included 2,474 homeless veterans with a current diagnosis of schizophrenia and a substance abuse or dependence disorder who were assessed in a community outreach program sponsored by the Department of Veterans Affairs. RESULTS: After adjustment for other relevant factors, receipt of disability payments showed no significant relationship to the number of days of substance use a month, even among frequent users of alcohol and drugs. CONCLUSIONS: Findings about substance use among the homeless veterans with serious mental disorders in this study provide no support for the assertion that disability payments exacerbate substance use.

Adult↗
PubMed2002

[Human immunodeficiency virus-positive cases among intravenous drug users].

AIM: The authors show human immunodeficiency virus positive cases among Hungarian intravenous drug users. PATIENTS/METHOD: The cases were identified by self-admittance (by the results of HIV screening), and by objective methods. The persons were studied by questionnaire on their risk behaviours (injecting and sexual behaviours). Treatment seeking (76 cases) and out-of-treatment (121 cases) groups were analysed. In the first group the self-admittance human immunodeficiency virus-status was taken into consideration, in the second group the objective human immunodeficiency virus-status was studied. RESULTS: In the treatment-seeking group three persons knew that they had been human immunodeficiency virus positive or had had Acquired Immunodeficiency Syndrome related disease. The three males were 25 year-old, homeless, and used heroine intravenously. In the out-of-treatment group one person was identified by objective test, who did not know his infection. This 20 year-old male used heroine and amphetamine intravenously, and his risk behaviour was not characteristic for intravenous drug users. CONCLUSION: In these cases the sexual transmission cannot be excluded, but it is pointed out, that the human immunodeficiency virus is present among intravenous drug users in Hungary. Taking into consideration the risk behaviours, these persons can transmit the disease through injecting and or sexual behaviours. In case of treatment seeking group, the treatment institutions (where the interviews took place) did not know the infections among their patients. According to their results, the authors call the attention to the human immunodeficiency virus infection among Hungarian intravenous drug users and they urge specific interventions for intravenous drug users.

Adult↗