Can the Holmes-Rahe Social Readjustment Rating Scale (SRRS) Be Used as a Suicide Risk Scale? An Exploratory Study

The objective of this research was to examine whether the Holmes-Rahe Social Readjustment Rating Scale, a life event scale, can be used to identify suicide attempters. The Holmes-Rahe Social Readjustment Rating Scale\u27s ability to identify suicide attempters was tested in 1183 subjects (478 suicide attempters, 197 psychiatric inpatients, and 508 healthy controls) using the Fisher Linear Discriminant Analysis and traditional psychometric methods. The Fisher Linear Discriminant Analysis outperformed traditional psychometric approaches (area under the curve: 0.85 vs. 0.78; p \u3c 0.05) and indicated that this scale may be used to identify suicide attempters. The life events that better characterized suicide attempters were change in frequency of arguments, marital separation, and personal injury. The Holmes-Rahe Social Readjustment Rating Scale may help identify suicide attempters

Unofficial policy: access to housing, housing information and social services among homeless drug users in Hartford, Connecticut

BACKGROUND: Much research has shown that the homeless have higher rates of substance abuse problems than housed populations and that substance abuse increases individuals' vulnerability to homelessness. However, the effects of housing policies on drug users' access to housing have been understudied to date. This paper will look at the "unofficial" housing policies that affect drug users' access to housing. METHODS: Qualitative interviews were conducted with 65 active users of heroin and cocaine at baseline, 3 and 6 months. Participants were purposively sampled to reflect a variety of housing statuses including homeless on the streets, in shelters, "doubled-up" with family or friends, or permanently housed in subsidized, unsubsidized or supportive housing. Key informant interviews and two focus group interviews were conducted with 15 housing caseworkers. Data were analyzed to explore the processes by which drug users receive information about different housing subsidies and welfare benefits, and their experiences in applying for these. RESULTS: A number of unofficial policy mechanisms limit drug users' access to housing, information and services, including limited outreach to non-shelter using homeless regarding housing programs, service provider priorities, and service provider discretion in processing applications and providing services. CONCLUSION: Unofficial policy, i.e. the mechanisms used by caseworkers to ration scarce housing resources, is as important as official housing policies in limiting drug users' access to housing. Drug users' descriptions of their experiences working with caseworkers to obtain permanent, affordable housing, provide insights as to how access to supportive and subsidized housing can be improved for this population

How much choice is there in housing choice vouchers? Neighborhood risk and free market rental housing accessibility for active drug users in Hartford, Connecticut

<p>Abstract</p> <p>Background</p> <p>Since the mid-1970s, the dominant model for U.S. federal housing policy has shifted from unit-based programs to tenant based vouchers and certificates, intended to allow recipients a choice in their housing and neighborhoods. Surprisingly little research has examined the question of where those with Section 8 housing vouchers are able to live, but some research suggests that voucher holders are more likely to reside in distressed neighborhoods than unsubsidized renter households. Further, federal housing policy has limited drug users' access to housing subsidies. In turn, neighborhood disorder has been associated with higher levels of injection drug risk behaviors, and higher drug-related mortality. This paper explores rental accessibility and neighborhood characteristics of advertised rental housing in Hartford CT.</p> <p>Methods</p> <p>Brief telephone interviews were conducted with landlords or management companies with units to rent in Hartford to explore housing accessibility measured as initial move in costs, credit and criminal background checks, and whether rental subsidies were accepted. These data were supplemented with in-depth interviews with landlords, shelter staff and active users of heroin, crack or cocaine. Apartments for rent were geocoded and mapped using <b>ArcGIS</b>. We used location quotients to identify areas where low-income rental housing is concentrated. Finally, we mapped apartments in relation to drug and violent arrest rates in each neighborhood.</p> <p>Results</p> <p>High security deposits, criminal background and credit checks limit housing accessibility even for drug users receiving vouchers. While most landlords or management companies accepted housing subsidies, several did not. Voucher units are concentrated in neighborhoods with high poverty neighborhoods. Landlords reported little incentive to accept rental subsidies in neighborhoods with low crime rates, but appreciated the guarantee provided by Section 8 in high crime neighborhoods that were less likely to attract applicants with good jobs and credit.</p> <p>Conclusion</p> <p>Housing vouchers in themselves do not greatly improve recipients' choice of neighborhood and voucher units are concentrated in the most distressed neighborhoods. Policy changes are needed to increase landlords' incentives to accept housing subsidies. Interventions to improve neighborhood conditions are needed to improve the probability of success for those recovering from drug addictions.</p

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Multi Stereo-based Pedestrian Detection by means of Daylight and Far Infrared Cameras

This article presents a tetra-vision (4 cameras) system for the detection of pedestrians by means of the simultaneous use of two far infrared and visible cameras stereo pairs. The main idea is to exploit the advantages of both far infrared and visible cameras to develop a system that combines the advantages of using far infrared or daylight technologies. Different approaches are used to process the two stereo flows in an independent fashion to produce a list of areas of attention that potentially contain pedestrians. Then, four different following approaches are used to refine and filter this list and to validate the presence of a pedestrian. Preliminary results show that the combined use of two vision systems as well as the use of different and independent validation steps enable the system to effectively detect pedestrians in different conditions of illumination and background

The Efficacy of CPAP in Neonates with Meconium Aspiration Syndrome: A Systematic Review and Meta-Analysis

Background: In neonates with meconium aspiration syndrome (MAS), continuous positive airway pressure (CPAP) may be more beneficial compared to endotracheal intubation (ETI). We evaluated the efficacy of CPAP in neonates with MAS. Methods: Four engines were used to search randomized clinical trials (RCTs). We used relative risk (RR) and mean difference (MD) with 95% confidence intervals (95%CI) to assess the effect on dichotomous and continuous outcomes, respectively. In addition, we used the Paule–Mandel (PM) random effects model due to the anticipated lack of events. Results: Three RCTs were included (n = 432). No significant difference was found in mortality (RR = 0.82; 95%CI = 0.54–1.25; I2 = 71%; p = 0.36), need for ventilation (RR = 0.49; 95%CI = 0.15–1.56; I2 = 71%; p = 0.57), and incidence of pneumothorax (RR = 1.24; 95%CI = 0.30–5.12; I2 = 0%; p = 0.77) in the CPAP group compared to the ETI group. Regarding secondary outcomes, compared to the ETI group, no significant differences were found in APGAR at one minute (MD = −1.01; 95%CI −2.97 to 0.94; I2 = 98%; p = 0.31), APGAR at 5 min (MD = −1.00; 95%CI = −2.96 to 0.95; I2 = 99%; p = 0.32), days of hospitalization (MD = −0.52; 95%CI = −1.46 to 0.42; I2 = 94%; p = 0.28), and cord pH (MD = 0.003; 95%CI = −0.01 to 0.02; I2 = 0%; p = 0.79). Conclusions: In patients with MAS, there is no significant effect of CPAP use compared to ETI on primary, specifically on mortality, need for ventilation, the incidence of pneumothorax, and secondary outcomes