Homelessness and housing problems in admitted psychiatric patients in Flanders, Belgium

Homelessness in psychiatric patients in Flanders, Belgium, has never been investigated. Advocacy groups from patients with lived experience of psychiatric disorders have sounded the alarm on the scarcity of suitable housing options, the strain on psychiatric institutions, and the challenges faced by social service workers. To investigate the extent of the problem a survey on the topic was initiated. A "homelessness-in-mental-health-questionnaire" was designed by experts in the field. The social services of all Flemish psychiatric hospitals and all psychiatric wards in general hospitals were contacted and invited to complete this survey. 24 of 70 contacted services responded. The total number of homeless patients in the inpatient setting on an annual basis are estimated to an average 19.5%. 18% of homeless patients remain longer in admission due to the lack of housing options. 13.7% of homeless psychiatric patients are referred to a community care facility such as an assisted living facility. Social service respondents reported spending an average of 27.4% of their work time on housing issues. The main focus points according to the respondents are the lack of priority measures for homeless psychiatric patients, psychiatric problems as a barrier to housing options and the shortage of adapted housing capacity. The conclusion of this study is the need for comprehensive policy interventions to ensure an adequate supply of suitable social housing for psychiatric patients, accessible mental health care, alternative housing options and crisis accommodation facilities. We propose a 10-point action plan on housing for psychiatric patients for policymakers and politicians

Screening for Hepatitis C Virus Reinfection Using a Behaviour-Based Risk Score among Men Who Have Sex with Men with HIV:Results from a Case–Control Diagnostic Validation Study

We assessed the predictive capacity of the HCV-MOSAIC risk score, originally developed for primary early HCV infection, as a screening tool for HCV reinfection in 103 men who have sex with men (MSM) with HIV using data from the MOSAIC cohort, including MSM with HIV/HCV-coinfection who became reinfected (cases, n = 27) or not (controls, n = 76) during follow-up. The overall predictive capacity of the score was assessed using the area under the receiver operating characteristic (AUROC) curve. The effects of covariates on the receiver operating characteristic (ROC) curve were assessed using parametric ROC regression. The score cut-off validated for primary early infection (≥2.0) was used, from which the sensitivity and specificity were calculated. The AUROC was 0.74 (95% confidence interval (CI) = 0.63–0.84). Group sex significantly increased the predictive capacity. Using the validated cut-off, sensitivity was 70.4% (95%CI = 49.8–86.2%) and specificity was 59.2% (95%CI: 47.3–70.4%). External validation from a cohort of 25 cases and 111 controls, all MSM with HIV, resulted in a sensitivity of 44.0% (95%CI = 24.4–65.1) and specificity of 71.2% (95%CI = 61.8–79.4). The HCV-MOSAIC risk score may be useful for identifying individuals at risk of HCV reinfection. In sexual health or HIV-care settings, this score could help guide HCV-RNA testing in MSM with a prior HCV infection.</p

Psychological Functioning in Non-binary Identifying Adolescents and Adults

Gender diverse individuals who do not conform to society’s binary gender expectations are more likely to experience difficulties in acceptance and in recognition of gender, compared to binary-identifying transgender people. This may accentuate the feeling that their gender identity is not socially recognized or validated. This study aimed to investigate psychological functioning among gender diverse adolescents and adults who identify beyond the binary gender spectrum. In both study populations, 589 clinically-referred gender diverse adolescents from the UK (n = 438 birth-assigned females and n = 151 birth-assigned males), and 632 clinically-referred gender diverse adults from the Netherlands (n = 278 birth-assigned females and n = 354birth-assigned males), we found that a higher degree of psychological problems was predicted by identifying more strongly with a non-binary identity. For adolescents, more psychological problems were related to having a non-binary gender identity and being assigned female at birth. In the adult population, experiencing psychological difficulties was also significantly related to having a stronger non-binary identity and having a younger age. Clinicians working with gender diverse people should be aware that applicants for physical interventions might have a broader range of gender identities than a binary transgender one, and that people with a non-binary gender identity may, for various reasons, be particularly vulnerable to psychological difficulties

Systematic review of gastrointestinal nematodes of horses from Australia

Background: Equine gastrointestinal nematodes (GINs) have been the subject of intermittent studies in Australia over the past few decades. However, comprehensive information on the epidemiology of equine GINs, the efficacy of available anthelmintic drugs and the prevalence of anthelmintic resistance (AR) in Australasia is lacking. Herein, we have systematically reviewed existing knowledge on the horse GINs recorded in Australia, and main aspects of their pathogeneses, epidemiology, diagnoses, treatment and control. Methods: Six electronic databases were searched for publications on GINs of Australian horses that met our inclusion criteria for the systematic review. Subsets of publications were subjected to review epidemiology, diagnoses, pathogeneses, treatment and control of GINs of horses from Australia. Results: A total of 51 articles published between 1950 to 2018 were included. The main GINs reported in Australian horses were cyathostomins (at least 28 species), Draschia megastoma, Habronema muscae, H. majus, Oxyuris equi, Parascaris equorum, Strongyloides westeri and Trichostrongylus axei across different climatic regions of Queensland, New South Wales, Victoria, and Western Australia. Nematodes are diagnosed based on the traditional McMaster egg counting technique, though molecular markers to characterise common GINs of equines were characterised in 1990s. The use of anthelmintic drugs remains the most widely-used strategy for controlling equine GIN parasites in Australia; however, the threshold of faecal egg count that should trigger treatment in horses, remains controversial. Furthermore, anthelmintic resistance within GIN population of horses is becoming a common problem in Australia. Conclusions: Although GINs infecting Australian horses have been the subject of occasional studies over the past few decades, the effective control of GIN infections is hampered by a generalised lack of knowledge in various disciplines of equine parasitology. Therefore, coordinated and focused research is required to fill our knowledge gaps in these areas to maximise equine health and minimise economic losses associated with the parasitic infections in Australia

The influence of fish, meat and polyunsaturated fat intakes on platelet phopholipid polyunsaturated fatty acid in male Melbourne Chinese and Caucasian

Objective: The aims of this study were to investigate (1) platelet phospholipid (PL) polyunsaturated fatty acid (PUFA) composition in subjects who were the Melbourne Chinese migrants, compared with those who were the Melbourne Caucasians and (2) the relationship between platelet PL PUFA and intake of fish, meat and PUFA.Design: Cross-sectional comparison of the Melbourne Chinese and Caucasians.Setting: Free-living male subjects.Subjects: Ninety-seven Melbourne Chinese migrants and 78 Melbourne Caucasians who were recruited in Melbourne.Outcome measures: Dietary intake was assessed using a semi-quantitative food frequency questionnaire. The platelet PUFA was measured by gas-liquid chromatography.Results: The Melbourne Chinese had significantly higher proportions of platelet PL 20:5n-3 (P=0.006), 22:6n-3 (P&lt;0.0001), total n-3 (P=0.027) and 22:5n-6 (P=0.0002), and a significantly higher intake of fish (P=0.012) and white meat (P=0.0045) compared with the Melbourne Caucasians. In addition, the Melbourne Chinese had significantly lower proportions of 20:3n-6 (P=0.023), 20:4n-6 (P&lt;0.002), 22:4n-6 (P&lt;0.0001), total n-6 (P=0.037), 22:5n-3 (P&lt;0.0001) and ratio of n-6/n-3 (P=0.011), and a significantly lower intake of red and total meat (P&lt;0.0001) than the Melbourne Caucasians. Fish consumption was significantly positively correlated with platelet PL 20:5n-3 and 22:6n-3, and significantly negatively correlated with 22:5n-3 (P&lt;0.05). Meat consumption was significantly positively correlated with 22:5n-3 and significantly negatively correlated with 22:5n-6, 20:5n-3 and 22:6n-3 (P&lt;0.05). Dietary PUFA intake was significantly positively correlated with 20:3n-6, 22:4n-6 and 22:5n-3, and significantly negatively correlated with 22:5n-6, 20:5n-3 and 22:6n-3 (P&lt;0.05).Conclusions: Compared with Caucasians, the Melbourne Chinese had a significantly higher level of platelet PL n-3 PUFA, which might contribute to the low CVD mortality in this population. Platelet PL 20:5n-3 and 22:6n-3 were significantly positively correlated with fish intake, and negatively significantly correlated with dietary intake of meat and PUFA, while 22:5n-3 was significantly positively correlated with dietary meat and PUFA intake, and significantly negatively correlated with fish intake. Dietary intake of PUFA and fish are potential confounding factors for assessing the effects of meat consumption on platelet PL individual PUFA. Dietary intake of PUFA and meat did not influence the incorporation of fish long chain n-3 PUFA to platelet PL in this study population.<br /