A Program Model for Women's Mental Health Support Services at the HomeStart Shelter for Women and Children in Chapel Hill, NC

The HomeStart shelter for women and children is located in Chapel Hill, NC within Orange County. The shelter is a component of the InterFaith Council of Social Service and has been offering a range of services to homeless women and children including meals, job coaching, health and mental health care, social work and case management during varying times since its opening in 1994. Currently, access to health care and mental health services is limited by funding allocation and lack of adequate resources. Partnerships with current agencies, such as the UNC Department of Psychiatry, will serve as a springboard for the expansion of mental health services available to the women of the shelter. This program and evaluation plan aims to describe existing programs from around the world addressing mental health services access through a literature review. The paper will then select key elements for the program plan and evaluation and begin to explore the rich historical context and present frameworks of mental health and homelessness within the nation and North Carolina. The theoretical basis of the program, its goals and objectives and a simplified overview of the plan in the form of a logic model will be provided. The paper content will provide a basis for the program plan, its implementation, program budget and evaluation process. The paper will end with a discussion of the initiative along with its strengths and weaknesses. Overall, it will serve as a road map for the next five years in achieving the goal of increasing mental health services access to the women of the HomeStart shelter.Master of Public Healt

Redox-sensitive DNA Binding by Homodimeric Methanosarcina Acetivorans MsvR is Modulated by Cysteine Residues

Background: Methanoarchaea are among the strictest known anaerobes, yet they can survive exposure to oxygen. The mechanisms by which they sense and respond to oxidizing conditions are unknown. MsvR is a transcription regulatory protein unique to the methanoarchaea. Initially identified and characterized in the methanogen Methanothermobacter thermautotrophicus (Mth), MthMsvR displays differential DNA binding under either oxidizing or reducing conditions. Since MthMsvR regulates a potential oxidative stress operon in M. thermautotrophicus, it was hypothesized that the MsvR family of proteins were redox-sensitive transcription regulators. Results: An MsvR homologue from the methanogen Methanosarcina acetivorans, MaMsvR, was overexpressed and purified. The two MsvR proteins bound the same DNA sequence motif found upstream of all known MsvR encoding genes, but unlike MthMsvR, MaMsvR did not bind the promoters of select genes involved in the oxidative stress response. Unlike MthMsvR that bound DNA under both non-reducing and reducing conditions, MaMsvR bound DNA only under reducing conditions. MaMsvR appeared as a dimer in gel filtration chromatography analysis and site-directed mutagenesis suggested that conserved cysteine residues within the V4R domain were involved in conformational rearrangements that impact DNA binding. Conclusions: Results presented herein suggest that homodimeric MaMsvR acts as a transcriptional repressor by binding Ma PmsvR under non-reducing conditions. Changing redox conditions promote conformational changes that abrogate binding to Ma PmsvR which likely leads to de-repression

Association of Type 1 Diabetes vs Type 2 Diabetes Diagnosed During Childhood and Adolescence With Complications During Teenage Years and Young Adulthood

The burden and determinants of complications and comorbidities in contemporary youth-onset diabetes are unknown

A Gendered Look at Latinx General Strain Theory

This study investigates gendered differences within Latinx experiences using a GST framework. We address four hypotheses: (1) Latinos and Latinas will vary in their degrees of risk for and resilience against criminal behavior; (2) Latinos and Latinas will experience strains to various degrees; (3) Latinos are more likely to respond to strain with violent and serious crime than Latinas due to the types of strains they face and their varying degrees of risk and resilience; and (4) ethnic identity will provide different degrees of resilience against violent and serious offending between Latinos and Latinas. Implications are discussed

Mental Illness and Racial Disparities in Correctional Staff-Involved Violence: An Analysis of Jails in the United States

In this study, we draw on theories of opportunity and focal concerns to examine how mental illness and race correspond to correctional staff-involved violence, particularly within the transient and diverse context of jails. Using a sample of 3,936 people incarcerated in jails from the 2011 to 2012 National Inmate Survey (NIS-3), we analyze how an individual’s mental health status (number of mental illness diagnoses) and race relates to the risk of staff-inflicted victimization. Using a series of Firth’s logistic regression models, we find that Black and Hispanic individuals are much more likely to be victims of correctional staff assault than their White counterparts. Those with one and two or more mental illness diagnoses are also at greater risk for staff-involved violence, respectively. Supplementary models show that those who suffer from serious mental illness are at particularly high risk for staff victimization. In a subsequent moderation analysis, we find that race does not condition the influence of mental health diagnoses on risk for staff-involved violence. Our findings reinforce the need for more research on correctional staff-involved violence and the implications of this research support calls for enhanced training of correctional staff regarding mental illness and racial bias

Does Victimization Reduce Self-control? A Longitudinal Analysis

Purpose: To examine the effect of victimization on self-control. Method: Five waves of data from the GREAT survey are analyzed; the effect of prior victimization on subsequent self-control is estimated using the dynamic panel generalized-method of moments. Results: Victimization reduces subsequent self-control in the near term. Conclusions: The findings point to another source of low self-control, help to explain why prior victimization is linked to subsequent victimization, and provide support for general strain theory – which predicts that strains such as victimization will reduce self-control

Does victimization reduce self-control? A longitudinal analysis

Purpose To examine the effect of victimization on self-control.Method Five waves of data from the GREAT survey are analyzed; the effect of prior victimization on subsequent self-control is estimated using the dynamic panel generalized-method of moments.Results Victimization reduces subsequent self-control in the near term.Conclusions The findings point to another source of low self-control, help to explain why prior victimization is linked to subsequent victimization, and provide support for general strain theory - which predicts that strains such as victimization will reduce self-control.

Reconsidering Systems-Based Practice: Advancing Structural Competency, Health Equity, and Social Responsibility in Graduate Medical Education.

Health inequities stem from systematic, pervasive social and structural forces. These forces marginalize populations and create the circumstances that disadvantage these groups, as reflected in differences in outcomes like life expectancy and infant mortality and in inequitable access to and delivery of health care resources. To help eradicate these inequities, physicians must understand racism, sexism, oppression, historical marginalization, power, privilege, and other sociopolitical and economic forces that sustain and create inequities. A new educational paradigm emphasizing the knowledge, skills, and attitudes to achieve health equity is needed.Systems-based practice is the graduate medical education core competency that focuses on complex systems and physicians' roles within them; it includes topics like multidisciplinary team-based care, patient safety, cost containment, end-of-life goals, and quality improvement. This competency, however, is largely health care centric and does not train physicians to engage with the complexities of the social and structural determinants of health or to partner with systems and communities that are outside health care.The authors propose a new core competency centered on health equity, social responsibility, and structural competency to address this gap in graduate medical education. For the development of this new competency, the authors draw on existing, innovative undergraduate and graduate medical pedagogy and public health, health services research, and social medicine frameworks. They describe how this new competency would inform graduate medical education and clinical care and encourage future physicians to engage in the work of health equity