Homeless Youth
Mobile Health Units
Pediculus
Alabama
Behavioral Medicine
Trench Fever
Phthiraptera
Lice Infestations
Los Angeles
Tokyo
Attitude to Death
Tuberculosis
Health Services Accessibility
The Montefiore community children's project: a controlled study of cognitive and emotional problems of homeless mothers and children. (1/676)
OBJECTIVES: This study compares the prevalence of emotional, academic, and cognitive impairment in children and mothers living in the community with those living in shelters for the homeless. METHOD: In New York City, 82 homeless mothers and their 102 children, aged 6 to 11, recruited from family shelters were compared to 115 nonhomeless mothers with 176 children recruited from classmates of the homeless children. Assessments included standardized tests and interviews. RESULTS: Mothers in shelters for the homeless showed higher rates of depression and anxiety than did nonhomeless mothers. Boys in homeless shelters showed higher rates of serious emotional and behavioral problems. Both boys and girls in homeless shelters showed more academic problems than did nonhomeless children. CONCLUSION: Study findings suggest a need among homeless children for special attention to academic problems that are not attributable to intellectual deficits in either children or their mothers. Although high rates of emotional and behavioral problems characterized poor children living in both settings, boys in shelters for the homeless may be particularly in need of professional attention. (+info)Disease patterns of the homeless in Tokyo. (2/676)
In recent years, homelessness has been recognized as a growing urban social problem in various countries throughout the world. The health problems of the homeless are considerable. The purpose of this study was to elicit, with sociodemographic profiles, the disease patterns among Tokyo's homeless. The subjects were 1,938 men who stayed at a welfare institution from 1992 to 1996. Diagnosed diseases/injuries and sociodemographic profiles were analyzed. The disease patterns of the homeless were compared to those of the male general population. Of the subjects, 8.3% were admitted to the hospital; 64.0% received outpatient care. Their observed morbidity rates by disease category were greater than those of the male general population in both Japan and Tokyo. Comorbidity of alcoholic psychosis/alcohol-dependent syndrome to both liver disease and pulmonary tuberculosis were greater than the average (P < .01). Construction work brought a higher risk of pulmonary tuberculosis (odds ratio = 2.0) and dorsopathies (odds ratio = 1.4) than did other jobs (P < .05). Disease patterns among the homeless in Tokyo were characterized by alcoholic psychosis/alcohol-dependence syndrome; liver disease; pulmonary tuberculosis; diabetes mellitus; fractures, dislocations, sprains, strains; hypertension; and cerebrovascular disease. Although the sociodemographic backgrounds of Tokyo's homeless have become more diverse, the principal occupation of the homeless was unskilled daily construction work, which underlay the characteristics of their disease patterns. (+info)Improving access to disability benefits among homeless persons with mental illness: an agency-specific approach to services integration. (3/676)
OBJECTIVES: This study evaluated a joint initiative of the Social Security Administration (SSA) and the Department of Veterans Affairs (VA) to improve access to Social Security disability benefits among homeless veterans with mental illness. METHODS: Social Security personnel were colocated with VA clinical staff at 4 of the VA's Health Care for Homeless Veterans (HCHV) programs. Intake assessment data were merged with SSA administrative data to determine the proportion of veterans who filed applications and who received disability awards at the 4 SSA-VA Joint Outreach Initiative sites (n = 6709) and at 34 comparison HCHV sites (n = 27 722) during the 2 years before and after implementation of the program. RESULTS: During the 2 years after the initiative began, higher proportions of veterans applied for disability (18.9% vs 11.1%; P < .001) and were awarded benefits (11.4% vs 7.2%, P < .001) at SSA-VA Joint Initiative sites. CONCLUSION: A colocation approach to service system integration can improve access to disability entitlements among homeless persons with mental illness. Almost twice as many veterans were eligible for this entitlement as received it through a standard outreach program. (+info)Mortality among homeless shelter residents in New York City. (4/676)
OBJECTIVES: This study examined the rates and predictors of mortality among sheltered homeless men and women in New York City. METHODS: Identifying data on a representative sample of shelter residents surveyed in 1987 were matched against national mortality records for 1987 through 1994. Standardized mortality ratios were computed to compare death rates among homeless people with those of the general US and New York City populations. Logistic regression analysis was used to examine predictors of mortality within the homeless sample. RESULTS: Age-adjusted death rates of homeless men and women were 4 times those of the general US population and 2 to 3 times those of the general population of New York City. Among homeless men, prior use of injectable drugs, incarceration, and chronic homelessness increased the likelihood of death. CONCLUSIONS: For homeless shelter users, chronic homelessness itself compounds the high risk of death associated with disease/disability and intravenous drug use. Interventions must address not only the health conditions of the homeless but also the societal conditions that perpetuate homelessness. (+info)Experiences and attitudes of residents and students influence voluntary service with homeless populations. (5/676)
OBJECTIVE: To assess the impact of two programs at the University of Pittsburgh, one that requires and one that encourages volunteer activity. In the program that requires primary care interns to spend 15 hours in a homeless clinic, we measured volunteer service after the requirement was fulfilled. In the program that encourages and provides the structure for first- and second-year medical students to volunteer, we assessed correlates of volunteering. MEASUREMENTS AND MAIN RESULTS: When primary care interns were required to spend time at homeless clinics, all (13/13) volunteered to work at the same clinic in subsequent years. Categorical interns without this requirement were less likely to volunteer (24/51; chi2 = 12.7, p >. 001). Medical students who volunteered were more likely to be first-year students, have previously volunteered in a similar setting, have positive attitudes toward caring for indigent patients, and have fewer factors that discouraged them from volunteering (p <. 01 for all) than students who did not volunteer. CONCLUSIONS: Volunteering with underserved communities during medical school and residency is influenced by previous experiences and, among medical students, year in school. Medical schools and residency programs have the opportunity to promote volunteerism and social responsibility through mentoring and curricular initiatives. (+info)Culture of Bartonella quintana and Bartonella henselae from human samples: a 5-year experience (1993 to 1998). (6/676)
Bartonella quintana and Bartonella henselae are fastidious gram-negative bacteria responsible for bacillary angiomatosis, trench fever, cat scratch disease, and endocarditis. During a 5-year period, we received 2,043 samples for culture of Bartonella sp. We found Bartonella sp. to be the etiologic agent in 38 cases of endocarditis, 78 cases of cat scratch disease, 16 cases of bacteremia in homeless people, and 7 cases of bacillary angiomatosis. We correlated the results of positive cultures with the clinical form of the disease, type of sample, culture procedure, PCR-based genomic detection, and antibody determination. Seventy-two isolates of B. quintana and nine isolates of B. henselae from 43 patients were obtained. Sixty-three of the B. quintana isolates and two of the B. henselae isolates, obtained from patients with no prior antibiotic therapy, were stably subcultured. The sensitivity of culture was low when compared with that of PCR-based detection methods in valves of patients with endocarditis (44 and 81%, respectively), skin biopsy samples of patients with bacillary angiomatosis (43 and 100%, respectively), and lymph nodes of cat scratch disease (13 and 30%, respectively). Serological diagnosis was also more sensitive in cases of endocarditis (97%) and cat scratch disease (90%). Among endocarditis patients, the sensitivity of the shell vial culture assay was 28% when inoculated with blood samples and 44% when inoculated with valvular biopsy samples, and the sensitivity of both was significantly higher than that of culture on agar (5% for blood [P = 0.045] and 4% for valve biopsy samples [P < 0.0005]). The most efficient culture procedure was the subculture of blood culture broth into shell vials (sensitivity, 71%). For patients with endocarditis, previous antibiotic therapy significantly affected results of blood culture; no patient who had been administered antibiotics yielded a positive blood culture, whereas 80% of patients with no previous antibiotic therapy yielded positive blood cultures (P = 0.0006). Previous antibiotic therapy did not, however, prevent isolation of Bartonella sp. from cardiac valves but did prevent the establishment of strains, as none of the 15 isolates from treated patients could be successfully subcultured. For the diagnosis of B. quintana bacteremia in homeless people, the efficiency of systematic subculture of blood culture broth onto agar was higher than that of direct blood plating (respective sensitivities, 98 and 10% [P < 10(-7)]). Nevertheless, both procedures are complementary, since when used together their sensitivity reached 100%. All homeless people with positive blood cultures had negative serology. The isolation rate of B. henselae from PCR-positive lymph nodes, in patients with cat scratch disease, was significantly lower than that from valves of endocarditis patients and skin biopsy samples from bacillary angiomatosis patients (13 and 33%, respectively [P = 0.084]). In cases of bacillary angiomatosis for which an agent was identified to species level, the isolation rate of B. henselae was lower than the isolation rate of B. quintana (28 and 64%, respectively [P = 0.003]). If culture is to be considered an efficient tool for the diagnosis of several Bartonella-related diseases, methodologies need to be improved, notably for the recovery of B. henselae from lymph nodes of patients with cat scratch disease. (+info)Outcome of long stay psychiatric patients resettled in the community: prospective cohort study. (7/676)
OBJECTIVE: To examine the outcome of a population of long stay psychiatric patients resettled in the community. DESIGN: Prospective study with 5 year follow up. SETTING: Over 140 residential settings in north London. SUBJECTS: 670 long stay patients from two London hospitals (Friern and Claybury) discharged to the community from 1985 to 1993. MAIN OUTCOME MEASURES: Continuity and quality of residential care, readmission to hospital, mortality, crime, and vagrancy. RESULTS: Of the 523 patients who survived the 5 year follow up period, 469 (89.6%) were living in the community by the end of follow up, 310 (59.2%) in their original community placement. A third (210) of all patients were readmitted at least once. Crime and homelessness presented few problems. Standardised mortality ratios for the group were comparable with those reported for similar populations. CONCLUSIONS: When carefully planned and adequately resourced, community care for long stay psychiatric patients is beneficial to most individuals and has minimal detrimental effects on society. (+info)Serologic evidence of rickettsialpox (Rickettsia akari) infection among intravenous drug users in inner-city Baltimore, Maryland. (8/676)
We tested single serum samples from 631 intravenous (i.v.) drug users from inner-city Baltimore, Maryland for serologic evidence of exposure to spotted fever group rickettsiae. A total of 102 (16%) individuals had titers > or = 64 to Rickettsia rickettsii by an indirect immunofluorescence assay. Confirmation that infection was caused by R. akari was obtained by cross-adsorption studies on a subset of serum samples that consistently resulted in higher titers to R. akari than to R. rickettsii. Current i.v. drug use, increased frequency of injection, and shooting gallery use were significant risk factors for presence of group-specific antibodies reactive with R. rickettsii. There was a significant inverse association with the presence of antibodies reactive to R. rickettsii and antibodies reactive to the human immunodeficiency virus. This study suggests that i.v. drug users are at an increased risk for R. akari infections. Clinicians should be aware of rickettsialpox, as well as other zoonotic diseases of the urban environment, when treating i.v. drug users for any acute febrile illness of undetermined etiology. (+info)There is no single, universally accepted medical definition of "homeless persons." However, in the public health and healthcare contexts, homeless individuals are often defined as those who lack a fixed, regular, and adequate nighttime residence. This can include people who are living on the streets, in shelters, vehicles, or other temporary or emergency housing situations. The McKinney-Vento Homeless Assistance Act, a major federal law in the United States that provides funding for homeless services programs, defines homeless individuals as those who lack a fixed, regular, and adequate nighttime residence, and includes people who are living in shelters, transitional housing, or doubled up with family or friends due to loss of housing, economic hardship, or similar reasons.
"Public housing" is a term used in the field of social welfare and public policy, rather than medicine. However, I can certainly provide you with a definition related to its housing context.
Public housing is a government-subsidized housing program that provides affordable rental housing for low-income individuals and families who cannot afford market-rate housing. These housing units are owned, managed, and maintained by government authorities, such as local housing agencies, which receive funding from the Department of Housing and Urban Development (HUD) in the United States or similar departments in other countries.
Public housing aims to provide safe, decent, and affordable living conditions for its residents, promoting social integration, community development, and economic mobility. Eligibility for public housing is typically based on income limits set by government regulations, and applicants must meet certain criteria related to citizenship status, background checks, and rental history.
There isn't a universally accepted medical definition for "Homeless Youth." However, in the context of social work, public health, and youth services, a homeless youth typically refers to an individual who is under the age of 25 and lacks fixed, regular, and adequate nighttime residence. This can include young people who are:
* Living on the streets, in parks, shelters, or other inadequate housing
* Couch surfing (moving from one place to another, staying with friends or relatives)
* Living in cars, abandoned buildings, or other inappropriate settings
* Fleeing or attempting to flee domestic violence or other dangerous situations
In the medical field, homeless youth may be at higher risk for various health issues, such as mental health disorders, substance abuse problems, chronic diseases, and infectious diseases. Therefore, healthcare providers should be aware of their unique needs and challenges to provide appropriate care and support.
Mobile Health Units (MHUs) are specialized vehicles or transportable facilities that deliver healthcare services in a flexible and accessible manner. They are equipped with medical equipment, supplies, and staff to provide a range of health care services, including preventive care, primary care, dental care, mental health services, and diagnostic screenings. MHUs can be deployed to various locations such as rural areas, underserved communities, disaster-stricken regions, and community events to increase access to healthcare for those who may not have easy access to medical facilities. They are an innovative solution to address health disparities and improve overall population health.
"Pediculus" is the medical term for a type of small, wingless parasitic insect that can be found in human hair and on the body. There are two main species that affect humans:
1. Pediculus humanus capitis - also known as the head louse, it primarily lives on the scalp and is responsible for causing head lice infestations.
2. Pediculus humanus corporis - also known as the body louse, it typically lives in clothing and on the body, particularly in seams and folds of clothing, and can cause body lice infestations.
Both species of Pediculus feed on human blood and can cause itching and skin irritation. They are primarily spread through close personal contact and sharing of items such as hats, combs, and clothing.
Health Planning Organizations (HPOs) are entities that are responsible for planning, coordinating, and evaluating health services within a specific geographic area. The primary goal of HPOs is to ensure the delivery of high-quality, cost-effective healthcare services that meet the needs of the population they serve.
HPOs may be involved in various activities, including:
1. Needs assessment: Identifying the health needs and priorities of the population, including any disparities or inequities in access to care.
2. Resource allocation: Deciding how to allocate resources to address identified needs and priorities.
3. Service planning: Developing plans for the delivery of healthcare services that are evidence-based, efficient, and effective.
4. Quality improvement: Monitoring and evaluating the quality of healthcare services and implementing strategies to improve them.
5. Coordination: Coordinating the delivery of healthcare services across different providers and settings to ensure continuity of care.
6. Advocacy: Advocating for policies and practices that promote health equity, access to care, and improved health outcomes.
HPOs can take various forms, including local health departments, regional health authorities, hospital networks, and other types of collaborative entities. They may be public or private, non-profit or for-profit, and their governance structures and funding mechanisms can vary widely.
Overall, the role of HPOs is to ensure that healthcare services are designed and delivered in a way that meets the needs of the population, improves health outcomes, and promotes health equity.
I apologize, but "Alabama" is not a medical term or condition. It is the name of one of the states in the United States of America, located in the southeastern region. The term "Alabaman" is used to describe someone from this state. If you have any questions related to medical terminology or health concerns, I would be happy to help answer those for you.
Behavioral medicine is a field of healthcare that focuses on the development and integration of behavioral and biomedical sciences in the promotion of health, prevention of illness, and treatment of disorders. It is an interdisciplinary approach that involves the collaboration of professionals from various fields, including psychology, psychiatry, medicine, nursing, social work, and public health.
Behavioral medicine recognizes that behavior plays a critical role in health outcomes and seeks to understand how behaviors such as diet, physical activity, sleep, stress management, and substance use can impact physical health. It also examines the psychological factors that can influence health, such as thoughts, emotions, and social support.
The goal of behavioral medicine is to develop interventions that target these modifiable risk factors to prevent or treat illness, improve quality of life, and reduce healthcare costs. These interventions may include individual counseling, group therapy, lifestyle modification programs, stress management techniques, and other evidence-based practices.
In summary, behavioral medicine is a medical specialty that focuses on the prevention, diagnosis, and treatment of disorders that result from the interaction of biological, behavioral, and environmental factors. It aims to promote health and well-being by addressing modifiable risk factors through evidence-based interventions.
Trench fever is a historical medical condition that primarily affected soldiers during World War I. It is caused by Bartonella quintana, a type of bacterium that is transmitted through the feces of body lice. The name "trench fever" comes from the fact that it was common among soldiers living in trenches, where poor hygiene and crowded conditions facilitated the spread of the disease.
Symptoms of trench fever include sudden onset of fever, severe headache, muscle pain, and a rash. The fever typically lasts for about five days and then recurs every four to six days, which is why it was also known as "five-day fever" or "recrudescence fever." Other symptoms can include fatigue, anemia, and swelling of the spleen and liver.
Trench fever is treated with antibiotics such as doxycycline or azithromycin. Prevention measures include good personal hygiene, such as regular bathing and changing clothes, as well as environmental controls to reduce louse populations, such as delousing stations and insecticides.
While trench fever is no longer a major public health concern, it remains an important historical medical condition that highlights the importance of hygiene and infection control in military settings.
Phthiraptera is an order of small parasitic insects, also known as lice. They are characterized by having a specialized body structure adapted for living in close association with birds and mammals. There are three main subgroups: Anoplura (sucking lice), Ischnocera (chewing lice), and Rhynchophthirina (large-biting lice). Lice can cause itching, discomfort, and spread diseases to their hosts.
A lice infestation, also known as pediculosis, is a condition characterized by the presence and multiplication of parasitic insects called lice on a person's body. The three main types of lice that can infest humans are:
1. Head lice (Pediculus humanus capitis): These lice primarily live on the scalp, neck, and behind the ears, feeding on human blood. They lay their eggs (nits) on hair shafts close to the scalp. Head lice infestations are most common in children aged 3-12 years old.
2. Body lice (Pediculus humanus corporis): These lice typically live and lay eggs on clothing, particularly seams and collars, near the body's warmest areas. They move to the skin to feed on blood, usually at night. Body lice infestations are more common in people who experience homelessness or overcrowded living conditions with limited access to clean clothing and hygiene facilities.
3. Pubic lice (Pthirus pubis): Also known as crab lice, these lice primarily live in coarse body hair, such as the pubic area, armpits, eyelashes, eyebrows, beard, or mustache. They feed on human blood and lay eggs on hair shafts close to the skin. Pubic lice infestations are typically sexually transmitted but can also occur through close personal contact with an infected individual or sharing contaminated items like bedding or clothing.
Symptoms of a lice infestation may include intense itching, tickling sensations, and visible red bumps or sores on the skin caused by lice bites. In some cases, secondary bacterial infections can occur due to scratching. Diagnosis is usually made through visual identification of lice or nits on the body or clothing. Treatment typically involves topical medications, such as shampoos, creams, or lotions, and thorough cleaning of bedding, clothing, and personal items to prevent reinfestation.
I'm sorry for any confusion, but "housing" is not a term that has a medical definition. In a general sense, housing refers to a place where someone lives, such as a house or apartment. If you have any questions related to healthcare, medicine, or health-related topics, I would be happy to try to help answer them.
I'm sorry for any confusion, but "Los Angeles" is not a medical term or concept. It is a city in the state of California, USA. If you have any questions related to medical topics, I would be happy to try and help answer them!
I'm sorry for any confusion, but "Tokyo" is not a medical term. It is the capital city of Japan and the country's largest metropolitan area. If you have any questions about medical terms or topics, I would be happy to help with those!
"Attitude to Death" is not a medical term per se, but it does refer to an individual's perspective, feelings, and beliefs about death and dying. It can encompass various aspects such as fear, acceptance, curiosity, denial, or preparation. While not a medical definition, understanding a person's attitude to death can be relevant in healthcare settings, particularly in palliative and end-of-life care, as it can influence their decisions and experiences around their own mortality.
Tuberculosis (TB) is a chronic infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs but can also involve other organs and tissues in the body. The infection is usually spread through the air when an infected person coughs, sneezes, or talks.
The symptoms of pulmonary TB include persistent cough, chest pain, coughing up blood, fatigue, fever, night sweats, and weight loss. Diagnosis typically involves a combination of medical history, physical examination, chest X-ray, and microbiological tests such as sputum smear microscopy and culture. In some cases, molecular tests like polymerase chain reaction (PCR) may be used for rapid diagnosis.
Treatment usually consists of a standard six-month course of multiple antibiotics, including isoniazid, rifampin, ethambutol, and pyrazinamide. In some cases, longer treatment durations or different drug regimens might be necessary due to drug resistance or other factors. Preventive measures include vaccination with the Bacillus Calmette-Guérin (BCG) vaccine and early detection and treatment of infected individuals to prevent transmission.
Substance-related disorders, as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), refer to a group of conditions caused by the use of substances such as alcohol, drugs, or medicines. These disorders are characterized by a problematic pattern of using a substance that leads to clinically significant impairment or distress. They can be divided into two main categories: substance use disorders and substance-induced disorders. Substance use disorders involve a pattern of compulsive use despite negative consequences, while substance-induced disorders include conditions such as intoxication, withdrawal, and substance/medication-induced mental disorders. The specific diagnosis depends on the type of substance involved, the patterns of use, and the presence or absence of physiological dependence.
Health services accessibility refers to the degree to which individuals and populations are able to obtain needed health services in a timely manner. It includes factors such as physical access (e.g., distance, transportation), affordability (e.g., cost of services, insurance coverage), availability (e.g., supply of providers, hours of operation), and acceptability (e.g., cultural competence, language concordance).
According to the World Health Organization (WHO), accessibility is one of the key components of health system performance, along with responsiveness and fair financing. Improving accessibility to health services is essential for achieving universal health coverage and ensuring that everyone has access to quality healthcare without facing financial hardship. Factors that affect health services accessibility can vary widely between and within countries, and addressing these disparities requires a multifaceted approach that includes policy interventions, infrastructure development, and community engagement.
Terminal care, also known as end-of-life care or palliative care, is a type of medical care provided to patients who are in the final stages of a terminal illness or condition. The primary goal of terminal care is to provide comfort, dignity, and quality of life for the patient, rather than attempting to cure the disease or prolong life.
Terminal care may involve managing pain and other symptoms, providing emotional and psychological support to both the patient and their family, and helping the patient plan for the end of their life. This can include discussing advance directives, hospice care options, and other important decisions related to end-of-life care.
The focus of terminal care is on ensuring that the patient's physical, emotional, and spiritual needs are met in a compassionate and supportive manner. It is an essential component of high-quality medical care for patients who are facing the end of their lives.
Patient-to-professional transmission of infectious diseases refers to the spread of an infectious agent or disease from a patient to a healthcare professional. This can occur through various routes, including:
1. Contact transmission: This includes direct contact, such as touching or shaking hands with an infected patient, or indirect contact, such as touching a contaminated surface or object.
2. Droplet transmission: This occurs when an infected person coughs, sneezes, talks, or breathes out droplets containing the infectious agent, which can then be inhaled by a nearby healthcare professional.
3. Airborne transmission: This involves the spread of infectious agents through the air over long distances, usually requiring specialized medical procedures or equipment.
Healthcare professionals are at risk of patient-to-professional transmission of infectious diseases due to their close contact with patients and the potential for exposure to various pathogens. It is essential for healthcare professionals to follow standard precautions, including hand hygiene, personal protective equipment (PPE), and respiratory protection, to minimize the risk of transmission. Additionally, proper vaccination and education on infection prevention and control measures can further reduce the risk of patient-to-professional transmission of infectious diseases.