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High prevalence of alcohol use among hepatitis C virus antibody positive injection drug users in three US cities.

Injection drug users (IDUs) acquire the majority of new hepatitis C virus (HCV) infections and frequently use alcohol. Alcohol abuse accelerates liver disease among HCV-infected persons, can reduce the effectiveness of treatment for HCV infection and may be a contraindication for HCV treatment. HCV seropositive, HIV-negative IDUs aged 18-35 years in Baltimore, New York City and Seattle who were enrolled in a behavioral risk-reduction intervention trial underwent computerized self-interviews to assess baseline alcohol use and dependence and medical history. We measured problem alcohol use using the 10-item Alcohol Use Disorders Identification Test (AUDIT) scale. Of 598 participants, 84% responded "false" to: "it is safe for a person with HCV to drink alcohol". Problem drinking, defined as score > or =8 on AUDIT, was identified in 37%. Correlates of scoring > or =8 on AUDIT included homelessness, male gender, primarily injecting speedballs, having injected with used needles, prior alcohol treatment and depression. Although most HCV seropositive IDUs in our sample appear informed about their increased risk of liver disease from alcohol, two-fifths screened positive for problem alcohol use. These findings underscore the importance of referring HCV-positive persons to effective alcohol treatment programs to reduce future liver damage and improve eligibility for and effectiveness of treatment of HCV.

Adolescent↗

The role of children's lay theories about the malleability of human attributes in beliefs about and volunteering for disadvantaged groups.

Two studies with 9- to 12-year-old children supported the hypothesis that lay theories about the malleability of human traits impact judgments of and behavior toward groups in need of volunteer help. The more children endorsed an incremental view (attributes can change), the more they reported liking, desiring social contact with, and perceiving similarity between themselves and a disadvantaged outgroup (homeless, UNICEF-funded children). Moreover, children endorsing more of a malleable view reported greater past volunteering, active participation in collecting money for a UNICEF event, and intentions to volunteer again. These findings held when controlling for the effects of participants' gender, self-esteem, and perceived social pressure to help others. How a malleable view and intergroup volunteerism may be mutually sustaining is discussed.

Attitude↗

Arthropod-borne diseases in homeless.

Homeless people are particularly exposed to ectoparasite. The living conditions and the crowded shelters provide ideal conditions for the spread of lice, fleas, ticks, and mites. Body lice have long been recognized as human parasites and although typically prevalent in rural communities in upland areas of countries close to the equator, it is now increasingly encountered in developed countries especially in homeless people or inner city economically deprived population. Fleas are widespread but are not adapted to a specific host and may occasionally bite humans. Most common fleas that parasite humans are the cat, the rat, and the human fleas, Ctenocephalides felis, Xenopsylla cheopis, and Pulex irritans, respectively. Ticks belonging to the family Ixodidae, in particular, the genera Dermacentor, Rhipicephalus, and Ixodes, are frequent parasites in humans. Sarcoptes scabiei var. hominis is a mite (Arachnida class) responsible for scabies. It is an obligate parasite of human skin. The hematophagic-biting mite, Liponyssoides sanguineus, is a mite of the rat, mouse, and other domestic rodents but can also bite humans. Finally, the incidence of skin disease secondary to infestation with the human bedbug, Cimex lectularius, has increased recently. Bacteria, such as Wolbacchia spp. have been detected in bedbug. The threat posed by the ectoparasite in homeless is not the ectoparasite themselves but the associated infectious diseases that they may transmit to humans. Except for scabies all these ectoparasites are potential vectors for infectious agents. Three louse-borne diseases are known at this time. Trench fever caused by Bartonella quintana (B. quintana), epidemic typhus caused by Rickettsia prowazekii, and relapsing fever caused by the spirochete Borrelia recurrentis. Fleas transmit plague (Xenopsylla cheopis and Pulex irritans), murine typhus (Xenopsylla cheopis), flea-borne spotted rickettsiosis on account of the recently described species Rickettsia felis (C. felis), and occasionally cat scratch disease on account of Bartonella henselae (C. felis). The role of fleas as potential vector of B. quintana has recently been suggested. Among the hematophagic-biting mites, L. sanguineus, is responsible for the transmission of Rickettsia akari, the etiologic agent of rickettsialpox. Virtually, no data are available on tick-borne disease in this population. This article will deal with epidemiology, diagnosis, prevention, and treatment of these ectoparasite and the infectious diseases they transmit to the homeless people.

Animals↗

Homeless and matched housed adolescents: a comparative study of psychopathology.

Compared a probability sample of 118 homeless adolescents (ages 12-17) from 6 shelters from throughout the 7-county Detroit metropolitan area to a matched sample of 118 housed adolescents using the Diagnostic Interview Schedule for Children (DISC), which yields diagnoses based on the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; DSM-III-R; American Psychiatric Association, 1987) criteria, and the Brief Symptom Inventory (BSI). Adolescents in the housed comparison group were matched on age, sex, race, and neighborhood characteristics. Analyses, including ones controlling for a set of 10 risk and resilience factors, indicated that the homeless showed more disruptive behavior disorders and alcohol abuse or dependence on the DISC and greater levels of symptomatology on the BSI. There were no significant group differences on drug abuse or affective disorders, and psychotic disorders were rare in both groups. This pattern of findings is not entirely consistent with popular stereotypes about homeless youth nor with many existing studies (which have often failed to include an appropriate comparison group).

Adolescent↗