Toward Housing Stability: Exiting Homelessness as an Emerging Adult

This paper explores the lives of formerly homeless young people as they transitioned towards housing stability. The study employed a longitudinal design involving 51 street youth in Halifax, N.S. (n = 21) and Toronto, ON (n = 30). This paper sheds light upon the pathways through which young people transitioned away from homelessness using the developmental lens of emerging adulthood: a stage involving numerous developmental struggles (identity, instability, self-focus, feeling in-between) but also an age filled with hope and possibilities. There are numerous interrelated factors at play that allow participants to regain a sense of citizenship with mainstream society. While housing in itself did not shape these young people\u27s sense of stability, it influenced feelings of health, happiness and security. Yet, our participants, as a particular segment of the youth population who have transitioned out of basic homelessness, continue to describe their current lives in terms of fragility and instability. For most, opportunity for experimentation and identity exploration was often curtailed by processes outside of their control and struggles with the consequences of profound disempowerment —past trauma with family and/or current struggles with public sector structures and services. As a result, many felt abandoned and stigmatized by the very resources whose mission it is to assist

Cognitive Remediation for Individuals with Psychosis in a Supported Education Setting: A Pilot Study

Cognitive remediation (CR) is a treatment approach that is being increasingly examined as a means through which the cognitive impacts of schizophrenia might be ameliorated. While CR has demonstrated good outcomes when paired with supported employment, little is known regarding how it might be integrated within supported education contexts. In this study CR was examined in a supported education context with 16 individuals with psychosis. The findings indicated that CR aligned well with the academic curriculum with very low attrition, was found useful by students, and showed similar pre-post differences on cognitive measures as those found in previous work

Climate change and its implications for developing brains – In utero to youth: A scoping review

The brain health and development implications of climate change are situated within a large and rapidly increasing body of evidence that addresses the physical and mental health impacts and implications of extreme and worsening environments. The costs to individuals and societies of negatively impacted brain development are profound – be it in the form of diagnosable developmental disability, reduced cognitive capacity, or areas of behavioral functioning. We have sought to describe the key risk domains that climate change presents with respect to healthy brain development, from the prenatal through to youth stages. Scoping review methods and an a priori search strategy were used to address the question: What are the major considerations of the peer-reviewed literature that address climate change as it relates to brain development and health from early development through to youth populations? Themes from the identified papers were charted, and findings were summarized through a consensus process. A total of 40 papers were identified in the search, spanning 2008–2022. Based on the thematic analysis, results are organized into the following nine themes: 1) heat extremes, 2) weather extremes and stress, 3) air pollution, 4) vector and waterborne illnesses, 5) malnutrition, 6) equity, 7) economic implications, 8) methods issues, and 9) responses. There is a clear consensus amongst the papers in this review suggesting that changing climate patterns and weather extremes have substantial and wide-ranging effects on developing brains. A range of responses are proposed with an emphasis upon early intervention and better data

Typology of mental health peer support work components: systematised review and expert consultation

The employment of mental health peer support (PS) is recommended in national and international mental health policy, and widely implemented across many countries. The key components of PS remain to be identified. This study aimed to develop a typology of components involved in one-to-one PS for adults in mental health services. A systematised review was performed to establish a preliminary long list of candidate components, followed by expert consultation (n = 21) to refine the list. Forty-two publications were full-text reviewed, comprising 26 trial reports, nine training manuals, and seven change model papers. Two hundred forty-two candidate components were identified, which were thematically synthesised to 16 components and eight sub-components, categorised into four themes: recruitment, preparation, practice, and PS worker wellbeing. Our typology can inform reflection and planning of PS practice, and allow more rigorous and synthesised studies, such as component network meta-analyses, to characterise the impact of each component and their interactions

Quasiparticle interference and strong electron-mode coupling in the quasi-one-dimensional bands of Sr2RuO4

The single-layered ruthenate Sr$_2$RuO$_4$ has attracted a great deal of interest as a spin-triplet superconductor with an order parameter that may potentially break time reversal invariance and host half-quantized vortices with Majorana zero modes. While the actual nature of the superconducting state is still a matter of controversy, it has long been believed that it condenses from a metallic state that is well described by a conventional Fermi liquid. In this work we use a combination of Fourier transform scanning tunneling spectroscopy (FT-STS) and momentum resolved electron energy loss spectroscopy (M-EELS) to probe interaction effects in the normal state of Sr$_2$RuO$_4$. Our high-resolution FT-STS data show signatures of the \beta-band with a distinctly quasi-one-dimensional (1D) character. The band dispersion reveals surprisingly strong interaction effects that dramatically renormalize the Fermi velocity, suggesting that the normal state of Sr$_2$RuO$_4$ is that of a 'correlated metal' where correlations are strengthened by the quasi 1D nature of the bands. In addition, kinks at energies of approximately 10meV, 38meV and 70meV are observed. By comparing STM and M-EELS data we show that the two higher energy features arise from coupling with collective modes. The strong correlation effects and the kinks in the quasi 1D bands may provide important information for understanding the superconducting state. This work opens up a unique approach to revealing the superconducting order parameter in this compound

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

HealthMap: a cluster randomised trial of interactive health plans and self-management support to prevent coronary heart disease in people with HIV

BACKGROUND: The leading causes of morbidity and mortality for people in high-income countries living with HIV are now non-AIDS malignancies, cardiovascular disease and other non-communicable diseases associated with ageing. This protocol describes the trial of HealthMap, a model of care for people with HIV (PWHIV) that includes use of an interactive shared health record and self-management support. The aims of the HealthMap trial are to evaluate engagement of PWHIV and healthcare providers with the model, and its effectiveness for reducing coronary heart disease risk, enhancing self-management, and improving mental health and quality of life of PWHIV. METHODS/DESIGN: The study is a two-arm cluster randomised trial involving HIV clinical sites in several states in Australia. Doctors will be randomised to the HealthMap model (immediate arm) or to proceed with usual care (deferred arm). People with HIV whose doctors are randomised to the immediate arm receive 1) new opportunities to discuss their health status and goals with their HIV doctor using a HealthMap shared health record; 2) access to their own health record from home; 3) access to health coaching delivered by telephone and online; and 4) access to a peer moderated online group chat programme. Data will be collected from participating PWHIV (n = 710) at baseline, 6 months, and 12 months and from participating doctors (n = 60) at baseline and 12 months. The control arm will be offered the HealthMap intervention at the end of the trial. The primary study outcomes, measured at 12 months, are 1) 10-year risk of non-fatal acute myocardial infarction or coronary heart disease death as estimated by a Framingham Heart Study risk equation; and 2) Positive and Active Engagement in Life Scale from the Health Education Impact Questionnaire (heiQ). DISCUSSION: The study will determine the viability and utility of a novel technology-supported model of care for maintaining the health and wellbeing of people with HIV. If shown to be effective, the HealthMap model may provide a generalisable, scalable and sustainable system for supporting the care needs of people with HIV, addressing issues of equity of access.<br /

Systematic Identification of Balanced Transposition Polymorphisms in Saccharomyces cerevisiae

High-throughput techniques for detecting DNA polymorphisms generally do not identify changes in which the genomic position of a sequence, but not its copy number, varies among individuals. To explore such balanced structural polymorphisms, we used array-based Comparative Genomic Hybridization (aCGH) to conduct a genome-wide screen for single-copy genomic segments that occupy different genomic positions in the standard laboratory strain of Saccharomyces cerevisiae (S90) and a polymorphic wild isolate (Y101) through analysis of six tetrads from a cross of these two strains. Paired-end high-throughput sequencing of Y101 validated four of the predicted rearrangements. The transposed segments contained one to four annotated genes each, yet crosses between S90 and Y101 yielded mostly viable tetrads. The longest segment comprised 13.5 kb near the telomere of chromosome XV in the S288C reference strain and Southern blotting confirmed its predicted location on chromosome IX in Y101. Interestingly, inter-locus crossover events between copies of this segment occurred at a detectable rate. The presence of low-copy repetitive sequences at the junctions of this segment suggests that it may have arisen through ectopic recombination. Our methodology and findings provide a starting point for exploring the origins, phenotypic consequences, and evolutionary fate of this largely unexplored form of genomic polymorphism

Asymmetric and symmetric stem-cell divisions in development and cancer

Much has been made of the idea that asymmetric cell division is a defining characteristic of stem cells that enables them to simultaneously perpetuate themselves (self-renew) and generate differentiated progeny. Yet many stem cells can divide symmetrically, particularly when they are expanding in number during development or after injury. Thus, asymmetric division is not necessary for stem-cell identity but rather is a tool that stem cells can use to maintain appropriate numbers of progeny. The facultative use of symmetric or asymmetric divisions by stem cells may be a key adaptation that is crucial for adult regenerative capacity.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/62868/1/nature04956.pd