Home as a base for a Well-Lived Life: Comparing the capabilities of homeless service users in housing first and the staircase of transition in Europe

Nussbaum’s Central Capabilities refer to the elements of a well-lived life, and many adults who experience homelessness are deprived of these capabilities. The study aim was to investigate whether service users experience different homeless services as affording or constraining capabilities. We conducted semi-structured interviews with homeless service users (n = 77) in Housing First (HF) and staircase services (SS) in eight European countries. We used thematic analysis to identify three themes: autonomy and dependency, the relational impact of living arrangements, and community interaction and stigma. While SS participants were able to address their bodily integrity and health, their higherorder capabilities were constrained by their homeless situations. HF participants described home as a base from which they could enact a wide range of capabilities indicative of a well-lived life. We conclude that housing-led service models with appropriate supports are key to affording service users’ capabilities. Practical and policy implications are discussed.Orizoninfo:eu-repo/semantics/publishedVersio

Factors associated with providers’ work engagement and burnout in homeless services: A cross‐national study

The complexity of homeless service users' characteristics and the contextual challenges faced by services can make the experience of working with people in homelessness stressful and can put providers' well-being at risk. In the current study, we investigated the association between service characteristics (i.e., the availability of training and supervision and the capability-fostering approach) and social service providers' work engagement and burnout. The study involved 497 social service providers working in homeless services in eight different European countries (62% women; mean age = 40.73, SD = 10.45) and was part of the Horizon 2020 European study "Homelessness as Unfairness (HOME_EU)." Using hierarchical linear modeling (HLM), findings showed that the availability of training and supervision were positively associated with providers' work engagement and negatively associated with burnout. However, results varied based on the perceived usefulness of the training and supervision provided within the service and the specific outcome considered. The most consistent finding was the association between the degree to which a service promotes users' capabilities and all the aspects of providers' well-being analyzed. Results are discussed in relation to their implications for how configuration of homeless services can promote social service providers' well-being and high-quality care.info:eu-repo/semantics/publishedVersio

Working with people experiencing homelessness in Europe

In Europe, the widespread transition from the Traditional Staircase (TS) model to the Housing First (HF) model is transforming the way social service providers work with people experiencing homelessness. This study examined social service providers’ perspectives in both models regarding factors that facilitate or hinder their work. Data were collected through 17 photovoice projects involving 81 social service providers from eight European countries. The results show factors affecting social service providers’ work at three levels: systemic, organizational, and individual. Professionals in TS and HF identified similar topics; however, TS providers discussed more obstacles to work. Implications for practice are discussed.Comissão Européiainfo:eu-repo/semantics/publishedVersio

Psychometric properties of the measure of achieved capabilities in homeless services

Background Purposeful participation in personally meaningful life tasks, enjoyment of positive reciprocal relationships, and opportunities to realize one’s potential are growth-related aspects of a meaningful life that should be considered important dimensions of recovery from homelessness. The extent to which homeless services support individuals to achieve the capabilities they need to become who they want to be and do what they want to do is, in turn, an important indicator of their efectiveness. In this study, we developed a measure of achieved capabilities (MACHS) for use in homeless services settings, and assessed its construct and concurrent validity. Methods We analysed data collected from homeless services users at two time points in eight European countries to assess the factor structure and psychometric properties of the new measure. Participants were adults engaged with either Housing First (n=245) or treatment as usual (n=320). Results Exploratory and confrmatory factor analyses yielded a four-factor structure of the capabilities measure: community integration, optimism, safety, and self-determination. We obtained evidence for construct validity through observed correlations between achieved capabilities and recovery, working alliance and satisfaction with services. Moreover, we obtained evidence of the measure’s concurrent validity from its positive association between HF and personal recovery, which was fully mediated by achieved capabilities. Conclusions Findings demonstrate that the MACHS is a valid and reliable measure that may be used to assess the extent to which homeless services support their clients to develop capabilities needed for growth-related recovery. Implications for practice and future research directions are discussed.info:eu-repo/semantics/publishedVersio

Psychometric properties of the measure of achieved capabilities in homeless services

Background Purposeful participation in personally meaningful life tasks, enjoyment of positive reciprocal relationships, and opportunities to realize one’s potential are growth-related aspects of a meaningful life that should be considered important dimensions of recovery from homelessness. The extent to which homeless services support individuals to achieve the capabilities they need to become who they want to be and do what they want to do is, in turn, an important indicator of their efectiveness. In this study, we developed a measure of achieved capabilities (MACHS) for use in homeless services settings, and assessed its construct and concurrent validity. Methods We analysed data collected from homeless services users at two time points in eight European countries to assess the factor structure and psychometric properties of the new measure. Participants were adults engaged with either Housing First (n=245) or treatment as usual (n=320). Results Exploratory and confrmatory factor analyses yielded a four-factor structure of the capabilities measure: community integration, optimism, safety, and self-determination. We obtained evidence for construct validity through observed correlations between achieved capabilities and recovery, working alliance and satisfaction with services. Moreover, we obtained evidence of the measure’s concurrent validity from its positive association between HF and personal recovery, which was fully mediated by achieved capabilities. Conclusions Findings demonstrate that the MACHS is a valid and reliable measure that may be used to assess the extent to which homeless services support their clients to develop capabilities needed for growth-related recovery. Implications for practice and future research directions are discussed.Horizon2020 of the European Commissioninfo:eu-repo/semantics/publishedVersio

Desarrollo de una aplicación web en Symfony 3 para un servicio de comida a domicilio

Treball Final de Grau en Enginyeria Informàtica. Codi: EI1054. Curs acadèmic: 2017/2018En este documento se describe el proceso de desarrollo de una aplicación web de servicio de comida a domicilio en Symfony. MealsOnWheels es una aplicación que permite a los usuarios clientes de los restaurantes convencionales pedir la comida de su restaurante favorito desde casa. Esta aplicación se ha creado usando la metodología de desarrollo ágil Scrum. El proyecto consta de tres partes, el front-end: una aplicación móvil enfocada a los clientes cuyo desarrollo no entra en el alcance de esta memoria, el dashboard: una aplicación web que ofrece la posibilidad de gestionar los restaurantes a sus propietarios y el back-end: una aplicación en el servidor que da soporte a los servicios web y al dashboard. El desarrollo de la aplicación se ha llevado a cabo durante la estancia en prácticas en la empresa Soluciones Cuatroochenta

Therapy of Ischemic Cerebral Vascular Disease Due to Atherothrombosis

Therapy for Transient Ischemic Attacks Surgical Therapy Carotid endarterectomy remains the mainstay of the therapy for TIAs that are caused by carotid stenosis. First introduced in 1954 by Eastcott et al., 104 the procedure has been associated with a morbidity ranging from 1 to 20 per cent, depending largely on the patient population and the experience of the surgeon. 42,55, 105 106 107 108 109 Although many studies suggest that this procedure is effective in preventing additional TIAs or strokes, 55, 105 106 107 , 109 , 110 its value is yet to be confirmed by a well-designed, controlled, randomized clinical trial. In the one multicenter controlled study published thus far, 24 centers randomly assigned . . 

Working with People Experiencing Homelessness in Europe

In Europe, the widespread transition from the Traditional Staircase (TS) model to the Housing First (HF) model is transforming the way social service providers work with people experiencing homelessness. This study examined social service providers’ perspectives in both models regarding factors that facilitate or hinder their work. Data were collected through 17 photovoice projects involving 81 social service providers from eight European countries. The results show factors affecting social service providers’ work at three levels: systemic, organizational, and individual. Professionals in TS and HF identified similar topics; however, TS providers discussed more obstacles to work. Implications for practice are discussed

European public perceptions of homelessness: A knowledge, attitudes and practices survey

Background Addressing Citizen’s perspectives on homelessness is crucial for the design of effective and durable policy responses, and available research in Europe is not yet substantive. We aim to explore citizens’ opinions about homelessness and to explain the differences in attitudes within the general population of eight European countries: France, Ireland, Italy, the Netherlands, Poland, Portugal, Spain, and Sweden. Methods A nationally representative telephone survey of European citizens was conducted in 2017. Three domains were investigated: Knowledge, Attitudes, and Practices about homelessness. Based on a multiple correspondence analysis (MCA), a generalized linear model for clustered and weighted samples was used to probe the associations between groups with opposing attitudes. Results Response rates ranged from 30.4% to 33.5% (N = 5,295). Most respondents (57%) had poor knowledge about homelessness. Respondents who thought the government spent toomuch on homelessness, people who are homeless should be responsible for housing, people remain homeless by choice, or homelessness keeps capabilities/empowerment intact (regarding meals, family contact, and access to work) clustered together (negative attitudes, 30%). Respondents who were willing to pay taxes, welcomed a shelter, or acknowledged people who are homeless may lack some capabilities (i.e. agreed on discrimination in hiring) made another cluster (positive attitudes, 58%). Respondents living in semi-urban or urban areas (ORs 1.33 and 1.34) and those engaged in practices to support people who are homeless (ORs > 1.4; p<0.005) were more likely to report positive attitudes, whereas those from France and Poland (p<0.001) were less likely to report positive attitudes. Conclusion The majority of European citizens hold positive attitudes towards people who are homeless, however there remain significant differences between and within countries. Although it is clear that there is strong support for increased government action and more effective solutions for Europe’s growing homelessness crisis, there also remain public opinion barriers rooted in enduring negative perception