Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Homeless Persons”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 811 records · Page 45Linked to original sources

Tuberculosis screening in Kansas City homeless shelters.

Voluntary tuberculin skin testing, coupled with on-site radiographic examination of persons with indurations > or = 10 mm, was conducted in five home-less shelters in Kansas City. Of 856 skin tests administered, 654 were read and 89 (13.6%) were positive. Males were nearly four times as likely to have a positive skin test than females. None of the positive individuals had abnormal chest radiographs. Of 42 persons who initiated preventive therapy, only eight completed the course of treatment.

Adolescent↗

Criminal victimization of persons with severe mental illness.

OBJECTIVE: The types and amounts of crime experienced by persons with severe mental illness were examined to better understand criminal victimization in this population. METHODS: Subjects were 331 involuntarily admitted psychiatric inpatients who were ordered by the court to outpatient commitment after discharge. Extensive interviews provided information on subjects' experience with crime in the previous four months and their perceived vulnerability to victimization, as well as on their living conditions and substance use. Medical records provided clinical data. RESULTS: The rate of nonviolent criminal victimization (22.4 percent) was similar to that in the general population (21.1 percent). The rate of violent criminal victimization was two and a half times greater than in the general population--8.2 percent versus 3.1 percent. Being an urban resident, using alcohol or drugs, having a secondary diagnosis of a personality disorder, and experiencing transient living conditions before hospitalization were significantly associated with being the victim of a crime. In the multivariate analysis, substance use and transient living conditions were strong predictors of criminal victimization; no demographic or clinical variable was a significant predictor. (Given the relatively high crime rates, subjects' perceived vulnerability to victimization was unexpectedly low; only 16.3 percent expressed concerns about personal safety. Those with a higher level of education expressed greater feelings of vulnerability. CONCLUSIONS: The study found a substantial rate of violent criminal victimization among persons with severe and persistent mental illness. Results suggest that substance use and homelessness make criminal victimization more likely.

Adult↗

Drug injection among street youths in Montreal: predictors of initiation.

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. Predictors of initiation were identified using Cox proportional hazard regression models. 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.

Adolescent↗

Depression and stress in street youth.

The present study explored stress and depression levels in Canadian street youth, as well as the methods they used to cope. Twenty-seven street youth and 27 nonrunaway peers responded to a questionnaire investigating history of running away, depression level, coping strategies, family history, and stress. Analyses revealed that stress and depression were positively correlated for the street youth, and that these youth had higher levels, compared with nonrunaways, of both. There were also differences in coping strategies: street youth were more likely to engage in acts of self-harm and to use drugs and alcohol, while nonrunaways more frequently resorted to productive problem solving and disclosure/discussion with someone they trust.

Adaptation, Psychological↗

Fostering health in the foster care maze.

The fastest growing population of children in foster care today is quite young, and many of these children have significant health care needs. The General Accounting Office (GAO) reported that children in foster care "are among the most vulnerable individuals in the welfare population" (GAO, 1995, p. 1). Poverty, increased homelessness, substance abuse, and a rise in the incidence of persons with HIV all contribute to the problems faced by these children. The Caring Communities for Children in Foster Care Project, funded by the Maternal Child Health Bureau Integrated Services Medical Home Initiative with the American Academy of Pediatrics (AAP), investigated the availability of comprehensive health care services for children in foster care. The AAP recommends that pediatricians serve as the primary health care provider for children in foster care and also as consultants to child welfare agencies. Pediatric nurses play a crucial role in providing health care services to children in foster care. With an increased understanding of the potential physical and mental health care needs of children in foster care and the important role of foster parents, pediatric nurses can increase the likelihood of positive health outcomes for children in foster care.

Adult↗

My life on the street.

In this first-person account, the author chronicles her experience of being mentally ill and homeless in New York and New Jersey in the early 1980s. She describes surviving numerous traumatic events until she eventually realized her need for treatment and admitted herself to a mental institution.

Autobiographies as Topic↗

Design and validation of the Health Professionals' Attitudes Toward the Homeless Inventory (HPATHI).

BACKGROUND: Recent literature has called for humanistic care of patients and for medical schools to begin incorporating humanism into medical education. To assess the attitudes of health-care professionals toward homeless patients and to demonstrate how those attitudes might impact optimal care, we developed and validated a new survey instrument, the Health Professional Attitudes Toward the Homeless Inventory (HPATHI). An instrument that measures providers' attitudes toward the homeless could offer meaningful information for the design and implementation of educational activities that foster more compassionate homeless health care. Our intention was to describe the process of designing and validating the new instrument and to discuss the usefulness of the instrument for assessing the impact of educational experiences that involve working directly with the homeless on the attitudes, interest, and confidence of medical students and other health-care professionals. METHODS: The study consisted of three phases: identifying items for the instrument; pilot testing the initial instrument with a group of 72 third-year medical students; and modifying and administering the instrument in its revised form to 160 health-care professionals and third-year medical students. The instrument was analyzed for reliability and validity throughout the process. RESULTS: A 19-item version of the HPATHI had good internal consistency with a Cronbach's alpha of 0.88 and a test-retest reliability coefficient of 0.69. The HPATHI showed good concurrent validity, and respondents with more than one year of experience with homeless patients scored significantly higher than did those with less experience. Factor analysis yielded three subscales: Personal Advocacy, Social Advocacy, and Cynicism. CONCLUSIONS: The HPATHI demonstrated strong reliability for the total scale and satisfactory test-retest reliability. Extreme group comparisons suggested that experience with the homeless rather than medical training itself could affect health-care professionals' attitudes toward the homeless. This could have implications for the evaluation of medical school curricula.

Adult↗

Comparative study of factors relating to HIV risk level of black homeless women.

A comparative study was conducted to assess factors that relate to level of HIV risk of black homeless women. The study examined whether 460 black women categorized as high, moderate, or low risk for HIV infection differed in environmental, demographic, and personal factors; appraisal of threat; resources; coping responses; and health outcome. Multivariate analyses of variance revealed high-risk homeless women reported statistically significant and greater concerns, appraisal of threat, emotion-focused coping, depression, and emotional distress, as well as less self-esteem and sense of coherence than moderate- and low-risk homeless women. Discriminant analyses revealed that women at high risk for HIV infection were best differentiated from moderate- and low-risk women by greater use of emotion-focused coping, greater severity of concerns, greater depression, and less self-esteem. An understanding of psychosocial factors most predictive of groups at highest risk for HIV infection provides impetus for interventional programs focused on altering the course of the disease in this population.

Adaptation, Psychological↗

Prevalence of HIV infection and HIV risk behaviors associated with living place: on-the-street homeless drug users as a special target population for public health intervention.

The study described here examined the prevalence of HIV infection as a function of place of residence and high-risk behaviors in six subpopulations of out-of-treatment drug injectors and crack cocaine users who participated in the National Institute on Drug Abuse (NIDA) Cooperative Agreement project. The subpopulations were blacks, Hispanics, and non-Hispanic whites sampled separately by gender. The research asked three questions: (a) Is the HIV infection rate higher among the on-the-street homeless than among those in other places of residence? (b) Do high-risk drug-related behaviors differ by housing status? and (c) What are the joint effects of high-risk drug-related behaviors and housing status on the probability of HIV infection? Overall, on-the-street homeless had a significantly higher HIV+ rate (19.0%) than the study population as a whole (11.2%). Rates differed by gender and race, with exceptionally high HIV+ rates for on-the-street homeless Hispanic males (29%) and females (32%) and for on-the-street homeless black females (38%). Having used drug works previously used by a HIV-infected person was a strong predictor of HIV+ status, as was frequency of drug injections and crack use. Having multiple sex partners was also a significant risk behavior. Findings argue against considering on-the-street homelessness as equivalent to shelter dwelling or aggregated homelessness for purposes of the AIDS epidemic. On-the-street homeless drug users were at strong risk for acquisition and transmission of HIV infection and therefore in need of targeted-racially relevant, ethnically relevant, and gender-relevant-public health interventions to help prevent the spread of AIDS.

HIV Infections↗

[A study of the mentally ill in institutions for homeless people in Tokyo].

Homeless problems associated with poverty may be considered almost resolved in Japan because of the post World War II economic development, but in large cities such as Tokyo the homeless are still being produced, a reflection of a variety of social problems. This study is based on an analysis of admission records of an institution for the homeless which was established in 1952 in Tokyo. Subjects are 2,122 single persons who were admitted between 1952 and 1985. Among these, 136 are mentally ill persons, who are the main subjects of analysis in this study. Results show that, which after 1970 the number of the mentally ill significantly increased, many of those people dropped out of the institution mostly because they were originally admitted directly from discharge from hospitals because there was no other place to go except the institutions, and also because the institution, originally meant to house street people who had been detained, did not offer appropriate programs for the mentally ill. A solution to these problems requires that roles of institutions for the homeless and subjects admitted be reconsidered. Institution staff should enrich programs designed for the homeless mentally ill and help them organize their social network and live in the community.

Adult↗

Walking Together: A Cross-Cultural Study of the Relationship Between Religiosity and Substance Use Disorder.

The literature suggests that religiosity is a protective factor for substance use. However, individuals with substance use disorder (SUD) may actively cultivate their religiosity during substance use. This qualitative study analyzed the perceptions and meanings homeless people attribute to their substance use trajectories and religiosity, as well as the potential connections between these two themes. The analysis was conducted based on the content analysis technique proposed by Bardin. A total of 40 semi-structured interviews were conducted with 20 Brazilian and 20 Portuguese participants. The present study found that religiosity can play a role in the substance use trajectory and the development of SUD by offering a subjective sense of protection, serving as a marker for the need for change, or providing relief from the suffering associated with SUD. We discuss how homeless people with SUD experience religiosity and how religious aspects traditionally seen as protective in the literature, such as church attendance, may paradoxically become risk factors for these socially vulnerable populations.

Humans↗