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The homeless.

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Health Services Needs and Demand↗

The causes of loneliness in homeless youth.

Both homelessness and loneliness are pervasive in North America. In this study, the author compared the causes of the loneliness experienced by young homeless youth (n = 113) with that of counterparts in the general population (n = 211) who answered a 30-item yes-no questionnaire. The results identified 5 causes of loneliness: personal inadequacy, developmental deficits, unfulfilling intimate relationships, relocation or significant separations, and social marginality. The results indicated that the causes of loneliness in young homeless youth are significantly different from those of the general population.

Adolescent↗

Tuberculosis and acquired immunodeficiency syndrome: a historical perspective on recent developments.

The incidence of tuberculosis has increased in recent years, at least in part as a result of the ongoing worldwide epidemic of acquired immunodeficiency syndrome (AIDS). In addition, the occurrence of outbreaks caused by multidrug-resistant Mycobacterium tuberculosis organisms has greatly heightened concern. In retrospect, a number of seminal studies that have appeared during the past decade have helped to define changing concepts concerning the epidemiology, pathogenesis, approaches to preventive care, diagnosis, and treatment of tuberculosis in HIV-infected persons. Such reports have shown that the variable clinical manifestations of tuberculosis in patients with AIDS are greatly influenced by the degree of HIV-induced immunosuppression. Explosive outbreaks of tuberculosis occurring in closed environments have emphasized that patients with AIDS and pulmonary tuberculosis may be highly contagious, especially when diagnosis and implementation of appropriate infection control measures are delayed. The extent to which homelessness and illicit drug use complicate management of tuberculosis have been examined, and the high risk of persons who are both tuberculin-positive and HIV-positive ultimately developing active tuberculosis, unless chemoprophylaxis is completed, has been clearly shown. The utility of sputum smears, bronchoscopy, and newer technologies such as polymerase chain reaction for diagnosis has been examined. The risk of relapse appears to be low when patients with AIDS with drug-sensitive tuberculosis complete appropriate multiple-drug therapy. Recent reports have addressed important hospital infection control, tuberculin testing, and chemoprophylaxis issues. This paper describes this evolution of understanding, focusing on reports that we believe have been conceptually important.

AIDS-Related Opportunistic Infections↗

Disability benefits and clinical outcomes among homeless veterans with psychiatric and substance abuse problems.

This study examined the relationship between disability payment status and clinical outcomes among 305 homeless veterans entering VA treatment. Disability status and clinical outcomes were characterized using self-report data at program entry, and quarterly for 2 years thereafter. Seeking or already receiving disability benefits at program entry was not associated with any of the 8 clinical outcomes examined. Those seeking or receiving disability benefits during the 2 years that followed showed more serious mental health problems and lower levels of mental health functioning, but no greater risk of substance use or not being employed nor worse housing outcomes than those who remained uninterested in applying for disability benefits. This study does not, therefore, support the notion that disability orientation results in poorer clinical outcomes, at least not among homeless veterans.

Adult↗

Theory of homelessness using Gibbs' paradigm.

An examination of homelessness is provided using Gibbs' paradigm as a guide. The author assesses national health objectives and health promotion and disease prevention for the homelessness population.

Health Promotion↗