Unsheltered homelessness among veterans: correlates and profiles

We identified correlates of unsheltered status among Veterans experiencing homelessness and describe d distinct subgroups within the unsheltered homeless Veteran population using data from a screening instrument for homelessness that is administered to all Veterans accessing outpatient care at a Veterans Health Administration (VHA) facility . Correlates o f unsheltered homelessness included male gender, white race, older age, lower levels of VHA eligibility, substance use disorders, frequent use of VHA inpatient and infrequent use of VHA outpatient services, and residing in the West. We identified six disti nct subgroups of unsheltered Veterans; the tri - morbid frequent users represented the highest need group, but the largest group was comprised of Veterans who made highly infrequent use of VHA healthcare services. Differences between sheltered and unshelter ed Veterans and heterogeneity within the unsheltered Veteran population should be considered in targeting housing and other interventions.National Center on Homelessness Among Veteran

Osteoporosis education in college-age women

Osteoporosis, a degenerative bone disease, is a preventable disease. The purpose of this study was to determine if an educational intervention would increase knowledge and influence women to change their behaviors (i.e., exercise and dietary calcium intake) related to osteoporosis. A random sample of 149 college female students participated in this study. Participants completed two questionnaires consisting of the Osteoporosis Knowledge Test and the Osteoporosis Self-Efficacy Scale. Participants were surveyed to determine their knowledge of osteoporosis and their intent to change their health behavior before and after an educational intervention. Statistical analysis indicated that an educational intervention increased the subjects’ knowledge about osteoporosis and elicited self-reported confidence level in health lifestyle behavioral changes. These findings suggest that an educational intervention is one strategy that can be implemented to bring about awareness of those at risk for osteoporosis and behavioral changes they can incorporate into their lives

Building intercultural understanding in an eighth grade social studies program through the study of Latin America

Thesis (M.A.)--Boston University, 1947. This item was digitized by the Internet Archive

“You don’t see them on the streets of your town”: challenges and strategies for serving unstably housed veterans in rural areas

Research on policy and programmatic responses to homelessness has focused largely on urban areas, with comparatively little attention paid to the rural context. We conducted qualitative interviews with a nationwide sample of rural-serving agencies receiving grants through the U.S. Department of Veterans Affairs’ Supportive Services for Veteran Families program to better understand the housing needs, available services, needed resources, and challenges in serving homeless and unstably housed veterans in rural areas. Respondents discussed key challenges—identifying unstably housed veterans, providing services within the rural resource context, and leveraging effective collaboration—and strategies to address these challenges. Unmet needs identified included emergency and subsidized long-term housing options, transportation resources, flexible financial resources, and additional funding to support the intensive work required in rural areas. Our findings identify promising programmatic innovations and highlight the need for policy remedies that are responsive to the unique challenges of addressing homelessness and housing instability in rural areas.Accepted manuscrip

Characteristics and likelihood of ongoing homelessness among unsheltered veterans

INTRODUCTION: Unsheltered homelessness is an important phenomenon yet difficult to study due to lack of data. The Veterans Health Administration administers a universal homelessness screener, which identifies housing status for Veterans screening positive for homelessness. METHODS: This study compared unsheltered and sheltered Veterans, assessed differences in rates of ongoing homelessness, and estimated a mixed-effect logistic regression model to examine the relationship between housing status and ongoing homelessness. RESULTS: Eleven percent of Veterans who screened positive for homelessness were unsheltered; 40% of those who rescreened were homeless six months later, compared with less than 20% of sheltered Veterans. Unsheltered Veterans were 2.7 times as likely to experience ongoing homelessness. DISCUSSION: Unsheltered Veterans differ from their sheltered counterparts-they are older, more likely to be male, less likely to have income-and may be good candidates for an intensive housing intervention. Future research will assess clinical characteristics and services utilization among this population

Abundance and diversity of tidal marsh plants along the salinity gradient of the San Francisco Estuary: implications for global change ecology

From 2003 through 2005, tidal marsh plant species diversity and abundance on historically surveyed vegetation transects along the salinity gradient of the San Francisco Estuary were investigated to establish empirical relationships between plant distributions and environmental conditions, and furthermore to examine and predict past and future plant distribution changes. This study suggests that for most species, salinity is the primary control on plant distribution. Thus, ongoing changes in estuarine conditions (increasing sea level and salinity) are resulting in a complex mix of plant distribution changes. On the low marsh, where sediment salinity is similar to that of ambient water, halophytic species are replacing salt-intolerant taxa. However, on marsh plains, where increased tidal flooding is moderating high salinity (concentrated by evaporation), halophytic “high marsh” species are being replaced by salt-intolerant “low marsh” taxa. Thus, future changes in plant distributions will hinge on whether marsh sediment accumulation keeps pace with sea level rise

Health technology assessment: a primer for ophthalmology

Rising healthcare costs and increasing demands for health care require techniques to choose between competing uses and even rationing of health care. Economic evaluations and health technology assessments are increasingly a means to assess the cost effectiveness of healthcare interventions so as to inform such resource allocation decisions. To date, the adoption of health technology assessments, as a way of assessing cost effectiveness, in ophthalmology has been slower, relative to their implementation in other specialities. Nevertheless, demands for eye services are increasing due to an ageing population. The prevalence of conditions such as glaucoma, cataract, diabetic eye disease and age-related macular degeneration increases with age, and it is predicted that global blindness will triple by 2050. So there is a challenge for ophthalmologists to ensure that they can contribute to, interpret, critically evaluate, and use findings from economic evaluations in their clinical practice. To aid this, this article serves as a primer on the use of health technology assessments to assess cost effectiveness using economic evaluation techniques for ophthalmologists. Healthcare systems face many challenges worldwide – changing demographics and evolution of new technologies are only going to intensify. With this in mind, ophthalmology needs to be ready and able to engage with health economists to prepare, interpret, critically evaluate and use findings of economic evaluations and health technology assessments

Needles in a haystack: screening and healthcare system evidence for homelessness

Effectiveness of screening for homelessness in a large healthcare system was evaluated in terms of successfully referring and connecting patients with appropriate prevention or intervention services. Screening and healthcare services data from nearly 6 million U.S. military veterans were analyzed. Veterans either screened positive for current or risk of housing instability, or negative for both. Current living situation was used to validate results of screening. Administrative evidence for homelessness-related services was significantly higher among positive-screen veterans who accepted a referral for services compared to those who declined. Screening for current or risk of homelessness led to earlier identification, which led to earlier and more extensive service engagement

Comparing the utilization and cost of health services between veterans experiencing brief and ongoing episodes of housing instability

Housing instability is associated with costly patterns of health and behavioral health service use. However, little prior research has examined patterns of service use associated with higher costs among those experiencing ongoing housing instability. To address this gap, we compared inpatient and outpatient medical and behavioral health service utilization and costs between veterans experiencing brief and ongoing episodes of housing instability. We used data from a brief screening instrument for homelessness and housing instability that has been implemented throughout the US Department of Veterans Affairs (VA) health care system to identify a national sample of veterans experiencing housing instability. Veterans were classified as experiencing either brief or ongoing housing instability, based on two consecutive responses to the instrument, and we used a series of two-part regression models to conduct adjusted comparisons of costs between veterans experiencing brief and ongoing episodes of housing instability. Among 5794 veterans screening positive for housing instability, 4934 (85%) were experiencing brief and 860 (15%) ongoing instability. The average total annual incremental cost associated with ongoing versus brief episodes of housing instability was estimated at $7573, with the bulk of this difference found in inpatient services. Cost differences resulted more from a higher probability of service use among those experiencing ongoing episodes of housing instability than from higher costs among service users. Our findings suggest that VA programmatic efforts aimed at preventing extended episodes of housing instability could potentially result in substantial cost offsets for the VA health care system.This study was supported by funding from the Department of Veterans Affairs (VA) Health Services Research & Development (HSR&D) grant IIR 13-334-3 and from the VA National Center on Homelessness Among Veterans

Elucidating Schwann cell reprogramming

The peripheral nervous system, unlike the central nervous system, has an exceptional capacity for regeneration following injury. This is due to the remarkable plasticity of the Schwann cells (SC), which are able to reprogramme, following injury, to a progenitor like cell which facilitates peripheral nerve repair. Current knowledge on the molecular basis of this reprogramming is incomplete and we are lacking a global overview of the transcriptional events that occur in SC following nerve injury and how these change over time. We aimed to characterise transcriptional changes in the SC, over time, following nerve injury using RNAseq. We also aimed to develop an in vitro dedifferentiation assay to use as a screening tool to asses potential key genes found using RNAseq. We developed a method of reliably extracting good quality, SC specific, RNA from the sciatic nerve of mice using fluorescence activated cell sorting. We performed RNAseq on SC from intact nerves and from the distal stump of nerves 6 days post transection. We validated this method by confirming differential expression of genes known to be up and downregulated following nerve injury, using RNAseq data. In analysing the RNAseq data we identified several potentially exciting, novel key molecular players in SC reprogramming, namely Myc and Runt-related transcription factor 1. We also developed an in vitro dedifferentiation assay to use as an initial screen for the genes identified using RNAseq. This involved the addition of neuregulin and serum to previously cyclic adenosine monophosphate differentiated SC. This assay was shown to recapitulate the changes seen in vivo, using RNAseq.Open Acces