Managing Health Without Stable Housing: Dimensions of Treatment Burden and Patient Capacity for People With Chronic Health Conditions Experiencing Homelessness.

Although chronic health conditions and homelessness are prevalent problems in the United States and globally, little research has used the lens of burden of treatment theory to examine the experiences of people facing these challenges simultaneously. This study aimed to illuminate dimensions of treatment burden, which refers to the work of being a patient with chronic conditions, and patient capacity to manage this burden in a sample of people experiencing homelessness and chronic health problems in Buffalo, New York, United States. We completed in-depth interviews with men and women recruited from a homelessness services organization ( = 27) and applied core concepts from burden of treatment theory to our analysis to probe how participants navigated tasks related to treatment and self-care.

Assessing NIAAA's Definition of Recovery from Alcohol Use Disorder: A Latent Class Analysis of a Heterogeneous Online Sample.

NIAAA's 2022 definition of recovery from alcohol use disorder (AUD) includes two core components, remission of DSM-5 AUD criteria and cessation of heavy drinking. This study's purpose was to assess patterns of AUD symptoms and heavy drinking in a heterogeneous national sample, in order to clarify the utility of the definition. Participants who self-reported having resolved an alcohol problem for at least six months were recruited through Amazon Mechanical Turk (=386) and surveyed about their problem severity, current drinking, and AUD symptomology.

Housing for care, connection, and health equity.

Researchers and policymakers have used a four-pillar framework- condition, consistency, context, and cost-to describe the characteristics of housing that are important for health equity. We propose adding a fifth pillar: care and connection. Housing for care and connection refers to the housing design, institutional policies, and housing programs that strengthen social connections, caregiving relationships, access to resources, and a sense of self in community.

Recovery capital profiles among a heterogeneous sample of individuals in recovery from alcohol problems.

Objective: Recovery capital (RC) is a framework for conceptualizing the resources individuals use to support alcohol and other drug recovery across social, physical, human, and cultural domains. The goal of this study was to identify subgroups of individuals in recovery with distinct combinations of RC across domains and characteristics of individuals with unique RC patterns.

Method: Latent profile analyses investigated patterns in both within-domain amount and variability of RC across each of the four domains using the Multidimensional Inventory of Recovery Capital, a theoretically and psychometrically sound RC measure.

We Rely on Relationships: Homeless Service Providers' Experiences in Coordinating Care Transitions During COVID-19.

Purpose Of Study: Care coordination occurring across multiple sectors of care, such as when professionals in health or social service organizations collaborate to transition patients from hospitals to community-based settings like homeless shelters, happens regularly in practice. While health services research is full of studies on the experiences of case management and care coordination professionals within health care settings, few studies highlight the perspective of nonclinical homeless service providers (HSPs) in coordinating care transitions.

Primary Practice Setting: This study explores the experience of nonclinical HSPs, employed in a large homeless service agency in New York, United States, responsible for coordinating care transitions of patients presenting to a homeless shelter after hospitalization, with attention to COVID-19 impact.

Exosomes from Von Hippel-Lindau-Null Cancer Cells Promote Metastasis in Renal Cell Carcinoma.

Exosomes are extracellular vesicles that modulate essential physiological and pathological signals. Communication between cancer cells that express the tumor suppressor gene and those that do not is instrumental to distant metastasis in renal cell carcinoma (RCC). In a novel metastasis model, VHL(-) cancer cells are the metastatic driver, while VHL(+) cells receive metastatic signals from VHL(-) cells and undergo aggressive transformation.

Development and psychometric properties of the Multidimensional Inventory of Recovery Capital (MIRC).

Background: Researchers have developed several instruments to measure recovery capital-the social, physical, human, and cultural resources that help people resolve alcohol and other drug problems. However, existing measures are hampered by theoretical and psychometric weaknesses. The current study reports on process and psychometric outcomes for the Multidimensional Inventory of Recovery Capital (MIRC), a novel measure of recovery capital.

Heart failure symptom burden in outpatient cardiology: observational cohort study.

Objectives: To assess the self-reported symptom burden in patients with a diagnosis of heart failure attending an outpatient cardiology clinic through the utilisation of validated patient-reported outcome measures.

Methods: Eligible patients were invited to partake in this observational cohort study. Participant demographics and comorbidities were recorded, followed by participants recording their symptoms using the Integrated Palliative care Outcome Scale (IPOS) and Brief Pain Inventory (BPI) outcome measure tools.

Qualitative insights in item development for a comprehensive and inclusive measure of recovery capital.

Background: Item specification is foundational to measurement development but rarely reported in depth. We address this gap by explicating our use of qualitative methods to ground and develop items for a new recovery capital measure, the Multidimensional Inventory of Recovery Capital.

Method: We recruited a diverse sample of service providers ( = 9) and people in recovery from alcohol problems ( = 23) to provide feedback on an item pool assessing social, human, physical, community, and cultural capital.

Trauma and principles of trauma-informed care in the U.S. federal legislative response to the opioid epidemic: A policy mapping analysis.

Objective: The U.S. declared the opioid epidemic as a national public health emergency in 2017.

A policy mapping analysis of goals, target populations, and punitive notions in the U.S. congressional response to the opioid epidemic.

Background: The U.S. Congress has proposed numerous bills and resolutions in response to the opioid epidemic unfolding over the past decade.

Psychometric Properties of the Assessment of Recovery Capital (ARC) Instrument in a Diverse Low-Income Sample.

Recovery capital is a theoretical construct elucidating the resources that support recovery from addiction. The 50-item Assessment of Recovery Capital (ARC) instrument and related brief-format versions are the predominant measures of this construct. However, some of the ARC's psychometric properties are not well-established, particularly in racially and economically diverse populations.

Food Insecurity Among Formerly Homeless Individuals Living in Permanent Supportive Housing.

Objectives: To assess the role of health-related factors, health care, nutrition, and socioeconomic factors in food insecurity prevalence in a sample of previously homeless adults living in permanent supportive housing.

Methods: In 2016 to 2017, we recruited and completed survey interviews with permanent supportive housing residents aged 45 years and older in Los Angeles, California (n = 237). We conducted univariable and multivariable analyses to determine the odds and covariates of low or very low food security, according to the US Department of Agriculture's definition and measure.

Socioeconomic determinants of pediatric asthma emergency department visits under regional economic development in western New York.

Although the links between asthma in children and physical environmental factors have been well established, the role of community-level socioeconomic status remains inconclusive. Consequently, little attention has been paid to the dynamic changes in the associations between socioeconomic status and asthma outcomes due to structural changes in the community, such as an influx of financial resources. This study examined the relationship between community-level socioeconomic status indicators and asthma-related emergency department utilization for school-aged children in 2011 and 2015, assessing the early impact of a large-scale regional economic development project in western New York, United States.

'Hello, you're not supposed to be here': homeless emerging adults' experiences negotiating food access.

Objective: We aimed to examine the food-seeking experiences of homeless emerging adults (age 18-24 years) in a US urban context.

Design: The study used a qualitative descriptive design, combining semi-structured interviews with a standardized quantitative measure of food insecurity. Interview data were coded using constant comparative methods to identify patterns across and within interviews.

A Trauma-Informed Analysis of the Violence Against Women Act's Provisions for Undocumented Immigrant Women.

Immigrant women in the United States are among the groups disproportionately affected by intimate partner violence (IPV). Undocumented immigrants generally have fewer resources for coping with violence and may experience a range of personal, cultural, and immigration status-related barriers to reporting violence and accessing help. Thus, undocumented immigrant victims of IPV could benefit significantly from policies that promote access to trauma-informed services and legal options.

A trauma-informed examination of the hardships experienced by abortion fund patients in the United States.

Researchers describe hardships experienced by abortion patients, examining administrative health cases from 2010 to 2015 in the United States. All patients received financial assistance from an abortion fund to help pay for abortion. Case data were analyzed to assess types and numbers of hardships experienced by age, race, and geographic origin.

Predictors of CD4 health and viral suppression outcomes for formerly homeless people living with HIV/AIDS in scattered site supportive housing.

Stable housing is key to improving health outcomes for people living with HIV/AIDS. Though many formerly homeless HIV positive individuals reside in supportive housing, little research has examined biometric HIV health outcomes for residents of these programs. Through a community-based research partnership, this study analyzed secondary data from a Shelter Plus Care supportive housing program in Cincinnati, Ohio to examine the likelihood of participants achieving a healthy CD4 count (>500 cells/mm) and viral suppression (viral load <200 copies/mL) while in supportive housing and to identify participant characteristics associated with these outcomes.

Descriptive and injunctive network norms associated with nonmedical use of prescription drugs among homeless youth.

Background: Nonmedical use of prescription drugs (NMUPD) among youth and young adults is being increasingly recognized as a significant public health problem. Homeless youth in particular are more likely to engage in NMUPD compared to housed youth. Studies suggest that network norms are strongly associated with a range of substance use behaviors.

Housing as a Social Determinant of Health: Exploring the Relationship between Rent Burden and Risk Behaviors for Single Room Occupancy Building Residents.

A growing body of health determinants research recognizes that housing and health are intimately linked. This study explores the relationship between rent burden (the ratio of rent to income) and health risk behaviors among a sample of single room occupancy (SRO) building residents. Cross-sectional data were gathered from a sample of 162 residents living in privately owned, for-profit SROs in Chicago.

A Multilevel Ecological Model of HIV Risk for People Who Are Homeless or Unstably Housed and Who Use Drugs in the Urban United States.

Elevated HIV prevalence has been observed among urban U.S. individuals who use drugs and who lack stable housing.

Trauma-Informed Social Policy: A Conceptual Framework for Policy Analysis and Advocacy.

Trauma-informed care is a service provision model used across a range of practice settings. Drawing on an extensive body of research on trauma (broadly defined as experiences that produce enduring emotional pain and distress) and health outcomes, we have argued that the principles of trauma-informed care can be extended to social policy. Citing a variety of health-related policy examples, we have described how policy can better reflect 6 core principles of trauma-informed care: safety, trustworthiness and transparency, collaboration, empowerment, choice, and intersectionality.

Prevalence and covariates of food insecurity among residents of single-room occupancy housing in Chicago, IL, USA.

Objective: Emerging evidence suggests that food insecurity is a significant public health concern among people who are homeless or marginally housed. The present study assessed prevalence of food insecurity and its covariates among a group of marginally housed individuals living in single-room occupancy (SRO) dwellings, a population for which there is little extant health or nutrition research.

Design: Cross-sectional survey incorporating the Household Food Insecurity Access Scale.

Klebsiella pneumoniae Infection: A Virulent Cause of Visual Loss.

Bacterial endophthalmitis is endogenous in 2-6% of cases and is frequently misdiagnosed initially. Klebsiella pneumoniae is being increasingly recognised as an aggressive causative organism, and it is particularly prevalent in Asian populations. We describe the case of a 71-year-old female of Southeast Asian origin with type 2 diabetes mellitus who presented with visual loss secondary to bacterial endophthalmitis and concomitant cerebral abscesses.