Homeless Drug Users' Awareness and Risk Perception of Peer Take Home Naloxone Use - A Qualitative Study

Background: Peer use of take home naloxone has the potential to reduce drug related deaths. There appears to be a paucity of research amongst homeless drug users on the topic. This study explores the acceptability and potential risk of peer use of naloxone amongst homeless drug users. From the findings the most feasible model for future treatment provision is suggested. Methods: In depth face-to-face interviews conducted in one primary care centre and two voluntary organisation centres providing services to homeless drug users in a large UK cosmopolitan city. Interviews recorded, transcribed and analysed thematically by framework techniques. Results: Homeless people recognise signs of a heroin overdose and many are prepared to take responsibility to give naloxone, providing prior training and support is provided. Previous reports of the theoretical potential for abuse and malicious use may have been overplayed. Conclusion: There is insufficient evidence to recommend providing over the counter take home naloxone to UK homeless injecting drug users. However a programme of peer use of take home naloxone amongst homeless drug users could be feasible providing prior training is provided. Peer education within a health promotion framework will optimise success as current professionally led health promotion initiatives are failing to have a positive impact amongst homeless drug users. (Authors)|28|1|Substance Abuse Treatment, Prevention and Policy|NULL|NULL|Jun 4 2007 11:51AM|1|NULL|NULL|Wright, Nat;Oldham, Nicola;Francis, Katherine;Jones, Lesley;|NULL|NULL|2006|NULL|48|NULL|0|NULL|NULL|http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1599711/pdf/1747-597X-1-28.pdf|[email protected]|NULL|NULL|6
26292|Sexual Risk Among Impoverished Women: Understanding the Role of Housing Status|HIV/AIDS increasingly affects women, and housing status is important to understanding HIV risk behaviors among women. The goal of this study is to enhance understanding of the association between housing status and a key sexual risk behavior, having multiple sex partners, by investigating the extent to which housing status differences can be accounted for by hypothesized explanatory factors. In a probability sample of 833 women in Los Angeles, results indicated that homeless African American and Hispanic women had from two to almost five times greater odds than low-income housed women of having multiple sex partners in the past 6 months. These disparities in risk behavior were accounted for by housing status differences in perceived susceptibility to HIV/AIDS, recent victimization by physical violence, drug use severity, and avoidant coping. Findings provide further evidence that interventions should address a multifaceted context of HIV risk for impoverished women. (Authors)|NULL|Online|AIDS and Behavior|NULL|NULL|Jun 4 2007 12:04PM|1|NULL|NULL|Wenzel, Suzanne;Tucker, Joan;Elliott, Marc;Hambarsoomians, Katrin;|NULL|NULL|2006|NULL|48|NULL|0|NULL|NULL|http://link.springer.com/article/10.1007/s10461-006-9193-4|[email protected]|310-393-0411|NULL|6
26293|Waltzing With a Monster: Bringing Research To Bear On Public Policy|Social scientists who want their research to influence social policy would do well to work with executive branch agencies, especially at state and local levels. Agency administrators are ready to use social science theories and evidence if the social science is brought to them. The article offers six principles for work with administrative agencies: (1) individual leaders matter, (2) timing matters, (3) ideas matter, (4) costs, and who bears the costs matter, (5) government is not monolithic, and (6) one cannot control the uses to which data are put. Working with government, like waltzing with a monster, is not unproblematic, but attending to these principles can help avoid some bruised toes. (Author)|1|63|Journal of Social Sciences|215-231|NULL|Jun 4 2007 12:09PM|0|NULL|NULL|Shinn, Marybeth;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://onlinelibrary.wiley.com/|[email protected]|NULL|NULL|6
26294|End-of-life Care for Homeless Patients: She Says She is There To Help Me in Any Situation|Homelessness annually affects an estimated 2.3 million to 3.5 million individuals living in the United States. Homeless people face difficulties in meeting their basic needs. Many have substance abuse problems and mental illness, lack social support, and have no medical insurance. These challenges complicate the homeless patient's ability to engage in end-of-life advanced planning, adhere to medications, and find an adequate site to receive terminal care. Employing a multidisciplinary team to care for homeless patients can help address their needs and improve care. For patients who continue to use illicit substances while receiving end-of-life care, experts recommend scheduling frequent clinic visits, using long-acting pain medications, dispensing small quantities of medications at a time, and using a written pain agreement. Homeless people are less likely to have a surrogate decision maker. Clinicians should have frequent, well-documented conversations with these patients about end-of-life wishes. Homeless people can rarely use hospice services because they lack the financial resources for inpatient hospice and have neither the home nor the social support required for home hospice. Developing inpatient palliative care services at hospitals that serve many homeless people could improve the end-of-life care homeless people receive. (Authors)|24|296|Journal of the American Medical Association|2959-2966||Jun 4 2007 12:10PM|1|NULL|NULL|Kushel, Margot;Miaskowski, Christine;|||2006||48||0|NULL|NULL|http://jama.jamanetwork.com/article.aspx?articleid=204716|||NULL|6
26295|Does Assigning a Representative Payee Reduce Substance Abuse?|BACKGROUND: Approximately 700,000 Social Security beneficiaries in the U.S. with psychiatric disabilities have been assigned a representative payee to manage their funds but it is unclear how those judged to need a payee differ from others and whether payee assignment improves clinical outcomes, especially substance abuse. METHODS: Participants in this observational 12-month cohort study (n=1457) received SSI or SSDI and had serious mental illness. They were subsequently enrolled at eighteen community-based sites that provided Assertive Community Treatment. Social Security administrative records were used to determine whether a payee had been assigned. RESULTS: At baseline, participants who were assigned a payee were more likely to have schizophrenia and had more severe clinician-rated drug and alcohol use than those not assigned a payee. In GEE models that adjusted for these and other potentially confounding covariates, participants assigned a payee between 4 and 12 months after program entry subsequently used significantly more psychiatric services than participants not assigned payees but showed no greater reduction in substance use. CONCLUSIONS: Although substance use is associated with being assigned a payee, substance use does not decline substantially following payee assignment. Participants assigned payees made greater subsequent use of psychiatric services, suggesting the potential for benefit from payee assignment. (Authors)|2-3|86|Drug and Alcohol Dependence|115-122||Jun 4 2007 12:17PM|1|||Rosen, Marc; McMahon, Thomas; Rosenheck, Robert; |||2007||48||0|NULL|NULL|http://www.ncbi.nlm.nih.gov/pubmed/16839710|||NULL|6
26296|Risk Factors for Recurrent Lower Extremity Cellulitis in a U.S. Veterans Medical Center Population|BACKGROUND: Despite the frequency of recurrent acute cellulitis of the lower extremities, factors associated with this infection have not been previously assessed in a case-control study among patients admitted to U.S. hospitals. METHODS: We compared the clinical characteristics of 47 patients with those of 94 age- and sex-matched control subjects admitted to the Miami Veterans Affairs Medical Center. RESULTS: In a multivariate analysis, two physical factors, lower extremity edema and body mass index, one behavioral factor, smoking, and one demographic factor, homelessness, were significantly and independently associated with recurrent cellulitis. The latter two factors have not previously been reported to be independently associated with cellulitis. CONCLUSIONS: Our results suggest that increased emphasis on weight loss, smoking cessation, and improved foot hygiene in the homeless might decrease recurrences of lower extremity cellulitis. (Authors)|6|332|The American Journal of the Medical Sciences|304-307||Jun 4 2007 12:20PM|1|||Lewis, Suzanne; Peter, Garnet; Gomez-Marin, Orlando; Bisno, Alan; |||2006||48||0|NULL|NULL|http://journals.lww.com/_layouts/1033/oaks.journals/Error/Unexpected.htm...|||NULL|6
26297|Demographics of the Homeless in An Urban Burn Unit|There are few articles about the homeless in burn literature. We sought to determine the demographic characteristics of the homeless citizens admitted to an urban burn center. This was a retrospective review from March 1999 to May 2004. Statistical analysis included chi2 and one-way analysis of variance. There were 1615 burn admissions, and 73 (4.5%) of these patients were homeless. Although the %TBSA affected was similar for the homeless and domiciled patients, the mean (+/-SD) age of the homeless was 44 +/- 10 years and their length of stay was 15 +/- 15 days, compared with 31 +/- 22 years and 9 +/- 13 days, respectively, for the domiciled. Twenty-one (29%) of the 73 homeless were admitted for frostbite, vs 21 (1.4%) of the 1542 domiciled patients (P= .000). Because of the frostbite, the majority (53%) arrived in the winter, compared with 15% in each of the other three seasons (P= .000). The homeless had a higher frequency of acute and chronic ethanol and cocaine use than the domiciled population (21% vs 6%). There was no significant difference between the homeless and the domiciled population in %TBSA affected, nutritional values, and assault frequency. More than half of the homeless patient admissions to the burn unit resulted from assault or frostbite. The homeless were mainly African-Americans and Caucasians, with a higher frequency of ethanol and cocaine use than in the domiciled burn population. Lack of discharge options for the homeless prolonged the average length of stay, leading to increased costs, often borne by the burn unit. (Authors)|1|28|Journal of Burn-Care and Research|105-110||Jun 4 2007 12:22PM|1|NULL|NULL|Kowal-Vern, A;Latenser, B.;|||2007||48||0|NULL|NULL||||NULL|6
26298|Arthropod-borne Diseases in Homeless|Homeless people are particularly exposed to ectoparasite. The living conditions and the crowded shelters provide ideal conditions for the spread of lice, fleas, ticks, and mites. Body lice have long been recognized as human parasites and although typically prevalent in rural communities in upland areas of countries close to the equator, it is now increasingly encountered in developed countries especially in homeless people or inner city economically deprived population. Fleas are widespread but are not adapted to a specific host and may occasionally bite humans. Most common fleas that parasite humans are the cat, the rat, and the human fleas, Ctenocephalides felis, Xenopsylla cheopis, and Pulex irritans, respectively. Ticks belonging to the family Ixodidae, in particular, the genera Dermacentor, Rhipicephalus, and Ixodes, are frequent parasites in humans. Sarcoptes scabiei var. hominis is a mite (Arachnida class) responsible for scabies. It is an obligate parasite of human skin. The hematophagic-biting mite, Liponyssoides sanguineus, is a mite of the rat, mouse, and other domestic rodents but can also bite humans. Finally, the incidence of skin disease secondary to infestation with the human bedbug, Cimex lectularius, has increased recently. Bacteria, such as Wolbacchia spp. have been detected in bedbug. The threat posed by the ectoparasite in homeless is not the ectoparasite themselves but the associated infectious diseases that they may transmit to humans. Except for scabies all these ectoparasites are potential vectors for infectious agents. Three louse-borne diseases are known at this time. Trench fever caused by Bartonella quintana (B. quintana), epidemic typhus caused by Rickettsia prowazekii, and relapsing fever caused by the spirochete Borrelia recurrentis. Fleas transmit plague (Xenopsylla cheopis and Pulex irritans), murine typhus (Xenopsylla cheopis), flea-borne spotted rickettsiosis on account of the recently described species Rickettsia felis (C. felis), and occasionally cat scratch disease on account of Bartonella henselae (C. felis). The role of fleas as potential vector of B. quintana has recently been suggested. Among the hematophagic-biting mites, L. sanguineus, is responsible for the transmission of Rickettsia akari, the etiologic agent of rickettsialpox. Virtually, no data are available on tick-borne disease in this population. This article will deal with epidemiology, diagnosis, prevention, and treatment of these ectoparasite and the infectious diseases they transmit to the homeless people. (Authors)||1078|Annals of the New York Academy of Science|223-235||Jun 4 2007 12:24PM|1|NULL|NULL|Brouqui, Philip;Raoult, Didier;|||2006||48||0|NULL|NULL|http://power.networksolutions.com/index.html|||NULL|6
26300|Leaving Jail: Service Linkage & Community Re-entry for Mothers With Co-occurring Disorders|The complex circumstances that lead to the incarceration of women require coordinated multi-agency solution. Mental health, substance abuse and trauma treatment as well as housing, entitlements, vocational and educational services, are critical elements in successful re-entry programming. In addition, detainees who are mothers and require special supports for themselves and their children. Beginning with the multi-agency desire to serve this population, the solution lies in coordinated systems of care. Partnerships between corrections and community are vital to successful reentry. (Author)||||||Jun 8 2007 12:36PM|0|||Gillece, Joan; |The National GAINS Center||2002|Delmar, NY|48||1|NULL|NULL|http://gainscenter.samhsa.gov/pdfs/Women/series/LeavingJail.pdf|[email protected]|800-311-4246|NULL|13
26302|Peer Support: What Makes It Unique?|Peer support in mental health has recently gained significant attention. There is increasing talk about funding and credentialing, standards and outcomes. But what is peer support and how is it different than services, even services delivered by people who identify themselves as peers? In this paper we would like to present a perspective on peer support that defines its difference and also maintains its integrity to the movement from which it came. We will offer some thinking about practice and evaluation standards that may help different types of peer initiatives sustain real peer support values in action. (Authors)|2|10|International Journal of Psychosocial Rehabilitation|29-37|NULL|Jun 8 2007 12:41PM|0|NULL|NULL|Mead, Shery;MacNeil, Cheryl;|NULL|NULL|2006|Plainfield, NH and Troy, NY|48|NULL|1|NULL|NULL|http://www.mentalhealthpeers.com/pdfs/PeerSupportUnique.pdf|[email protected]|603-469-3577|NULL|6
26304|Understanding What Useful Help Looks Like: the Standards of Peer Support|In this article we would like to share findings about how peer support is providing a positive alternative for people accessing the mental health system. “When consumers/survivors talk about what helps them, they generally credit some person who believed in them, who respected them; someone who made a genuine person-to-person connection with them” (Bassman, 2001, p. 22). These are the kinds of interactions we hear people talking about when they are involved in peer support. (Authors)|NULL|NULL|NULL|NULL|NULL|Jun 8 2007 12:48PM|0|NULL|NULL|MacNeil, Cheryl;Mead, Shery;|Copeland Center For Wellness and Recovery|NULL|2003|Chandler, AZ|48|NULL|1|NULL|NULL|http://www.akmhcweb.org/Articles/PeerSupport.pdf|[email protected]|518-244-2349|NULL|23
26305|Academic Consumer Researchers: a Bridge Between Consumers and Researchers|Objective: To describe the contributions that consumers, and academic consumer researchers in particular, can make to mental health research. Method: A literature survey and a systematic consideration of the potential advantages of consumer and academic consumer researcher involvement in health research. Results: Consumer researchers may contribute to better health outcomes, but there are significant barriers to their participation in the research process. To date, discussion has focused on the role of nonacademic consumers in the health research process. There has been little recognition of the particular contributions that consumers with formal academic qualifications and research experience can offer. Academic consumer researchers (ACRs) offer many of the advantages associated with lay consumer participation, as well as some unique advantages. These advantages include acceptance by other researchers as equal partners in the research process; skills in research; access to research funding; training in disseminating research findings within the scientific community; potential to influence research funding and research policy; capacity to influence the research culture; and potential to facilitate the involvement of lay consumers in the research process. In recognition of the value of a critical mass of ACRs in mental health, a new ACR unit (the Depression and Anxiety Consumer Research Unit [CRU]) has been established at the Centre for Mental Health Research at the Australian National University. Conclusions: Academic consumer researchers have the potential to increase the relevance of mental health research to consumers, to bridge the gap between the academic and consumer communities and to contribute to the process of destigmatizing mental disorders. (Authors)|4|38|Australia and New Zealand Journal of Psychiatry|191-196||Jun 8 2007 12:58PM|1|||Griffiths, Kathleen; Jorm, Anthony; Christensen, Helen; |||2004||48||1|NULL|NULL|http://www.ncbi.nlm.nih.gov/pubmed/15038796|[email protected]||NULL|6
26306|Influencing the National Policy Process: the Role of Health Consumer Groups|INTRODUCTION: Whilst recent research has focused on consumer involvement at local level in the UK, there have been few studies of the representation of user, carer and patients' interests nationally. This paper concentrates on the role of health consumer groups in representing the collective interests of patients, users and carers in the national policy process. METHODS: The research consisted of (a) a semi-structured postal questionnaire survey of 123 health consumer groups; (b) semi-structured interviews with key informants from 39 health consumer groups; and (c) semi-structured interviews with 31 policy actors. RESULTS: Health consumer groups were diverse in their origins, scope and structure, and undertook a wide range of activities relating to policy and service provision. Whilst around half the groups described their primary purpose as service provision, over four-fifths identified influencing policy at national level as 'very important' or 'important'. Health consumer groups had developed relationships with civil servants, ministers, MPs and peers to widen their policy objectives. Key facilitators in the policy process included experiential knowledge, relationships with policy makers and working in alliances with other health consumer groups or other stakeholders. Key barriers included problems relating to the political agenda, problems with the consultation process, lack of resources and working within a context of unequal power relationships. CONCLUSION: Health consumer groups are becoming increasingly involved in the health policy process and collectively are becoming an increasingly influential stakeholder. They have a key role to play in ensuring that the patient, user and carer voice is heard in the policy process. (Authors)|NULL|7|Health Expectations|18-28|NULL|Jun 8 2007 1:01PM|1|NULL|NULL|Jones, Kathryn;Baggott, Rob;Allsop, Judith;|NULL|NULL|2004|NULL|48|NULL|1|NULL|NULL|http://onlinelibrary.wiley.com/|[email protected]|NULL|NULL|6
26307|Parent Partners: Here To Support Your Sucess!|Minnesota has taken the step of involving parents to keep children safe. Minnesota continues to look at the child welfare, juvenile court and alcohol and other drug systems through the eyes of the child. Parents are rallying to help families address alcohol and other drug problems and successfully navigate the court and treatment processes. This handbook should provide the basic information needed to explore, identify, define and create a Parent Partner Network tailor-made especially for your community. (Authors)|NULL|NULL|NULL|NULL|NULL|Jun 8 2007 1:05PM|0|NULL|NULL|NULL|Children's Justice Initiatice Alcohol and Other Drugs Project|NULL|NULL|NULL|48|NULL|1|NULL|NULL|NULL|NULL|NULL|NULL|13
26308|'Victoria On the Move': Mental Health Services in a Decade of Transition 1992-2002|Objective: Australia adopted a national mental health strategy in the early 1990s and each State has had to go through its own implementation process in the intervening years. The present paper describes the process of reform in services in Victoria, and ventures explanations as to why the process may have been more comprehensive and successful than in other States. Conclusions: Victoria adopted a Statewide 'framework', defining structural elements of area-based services, with rational resource distribution. A transitional process involving a population health approach and relatively rigid implementation of a tightly specified service framework, within a political enviroment that favoured strong health services management, was successful in achieving desired structural reforms in this State. This was undoubtedly at the cost of promoting a model of public mental health service delivery that is generally rationed so as to accept only a restricted range of types of referral. New initiatives from the current State government are explicitly targeted to correcting this situation. (Authors)|1|11|Australasian Psychiatry|62-67||Jun 8 2007 1:08PM|0|||Meadows, Graham; Singh, Bruce; |||2003||48||1|NULL|NULL|http://apy.sagepub.com/content/11/1/62.full|[email protected]||NULL|6
26311|The Role of the Consumer in the Leadership and Management of Mental Health Services|Objective: To reflect on consumer involvement in the leadership and management of mental health services through consideration of relevant policy directives, pertinent literature and current practice, and to consider the role of psychiatrists in promoting consumer involvement. Conclusions: Both Australia and New Zealand have significant policy directives in relation to consumer involvement in mental health services. The actual realization of consumer involvement within the mental health sector is extremely variable and the extent of genuine participation highly questionable, particularly in regard to leadership and management roles. It is important that the rationale for consumer involvement is continually highlighted and understood by all mental health professionals, including psychiatrists, so as to discourage the practice of including consumers solely for the sake of adhering to political policies. The attitudes of health professionals have been identified as having the most significant impact on consumer involvement. It is questionable whether the critical contribution of consumer involvement in mental health services should remain dependant on the attitudes of non-consumers within the sector. In New Zealand, a paradigm shift is occurring with consumer involvement moving from a construct of ‘participation’ to one of ‘leadership’. Psychiatrists can, and should, play a significant role in advocating for the development of mental health services in directions which support and promote consumer involvement at all levels. (Author)|4|13|Australasian Psychiatry|362-365|NULL|Jun 8 2007 1:29PM|1|NULL|NULL|Gordon, Sarah;|NULL|NULL|2005|NULL|48|NULL|1|NULL|NULL|http://onlinelibrary.wiley.com/|[email protected]|NULL|NULL|6
26317|Experience and Meaning of User Involvement: Some Explorations From a Community Mental Health Project|With an increased interest in and policy commitment to involving service users in the planning and delivery of health service provision, there is a clear need to explore both the rhetoric and realities of what user involvement entails. In the present paper, by drawing upon an evaluation of a community-based exercise facility for people with mental health problems, the authors explore ways in which the reality of user involvement is subject to a range of configurations within health services. The paper describes a piece of qualitative research that was undertaken within a participatory framework to explore the nature of user involvement within the facility. The data have been analyzed using a grounded theory approach to provide insights into: the organizational context in which user involvement takes place; factors which encourage meaningful participation on the part of service users; perceived barriers to user involvement; and issues of sustainability and continuity. This research approach has enabled the authors to explore the views and experiences of users, service providers and referral agencies in relation to the nature and potential for user involvement. The findings illustrate ways in which user involvement may take place under both flexible and formal arrangements across a variety of activities. The present paper provides an account of some of the meanings and experiences of what 'successful' user participation may involve and the conditions which underpin 'success'. The authors conclude that successful and meaningful user involvement should enable and support users to recognize their existing skills, and to develop new ones, at a pace that suits their particular circumstances and personal resources. This process may require adaptation not only by organizations, but also by service providers and non-involved users. (Authors)|3|10|Health and Social Care in the Community|136-143|NULL|Jun 8 2007 1:51PM|1|NULL|NULL|Truman, Carole;Raine, Pamela;|NULL|NULL|2002|NULL|48|NULL|1|NULL|NULL|http://onlinelibrary.wiley.com/|[email protected]|NULL|NULL|6
26318|Trust, Choice and Power in Mental Health: A Literature Review|Trust, choice and empowerment of patients are emerging as important issues in mental health care. This may be due to an increasingly consumerist attitude amongst patients and as a consequence of postmodern cultural changes in society. This study aimed to find evidence for the influence of trust, patient choice and patient empowerment in mental health care. A literature review was undertaken. Six searches of PubMed were made using the key terms trust, patient choice and power combined separately with psychiatry and mental health. The literature search found substantial research evidence in the areas of trust, choice and power including validated scales measuring these concepts and evidence that they are important to patients. Trust in general health clinicians was found to be high and continuity of care increases patients' trust in their clinician. However, only qualitative research has been found on trust in mental health settings and further quantitative studies are needed. Patient choice is important to patients and improves engagement with services, although studies on outcome show varying results. Empowerment has impacted more at an organisational level than on individual care. Innovative research methodologies are needed to expand on the present significant body of research, utilising qualitative and quantitative techniques. (Authors)|NULL|41|Soc Psychiatry Psychiatr Epidemiol|843-852|NULL|Jun 8 2007 1:55PM|1|NULL|NULL|Laugharne, Richard;Priebe, Stefan;|NULL|NULL|2006|NULL|48|NULL|1|NULL|NULL|NULL|[email protected]|NULL|NULL|6
26319|After the Crisis: Peer Support Issue Brief|Emergency response protocols generally focus on addressing the basic survival needs of survivors and, from a psychological trauma perspective, employing early interventions to trauma histories, mental health concerns, or few personal and emotional supports, intermediate and long-term assistance is needed, Peer support presents a cost-effective, accessible, personal, and community-driven approach to filling that need. Peer support is widely regarded as an effective means of helping survivors of disaster through stress and trauma. A compliment to professional services, peer support provides individuals with the connection, understanding, validation, and support that are essential to the healing process. There are a number of models that have proven to be very effective in reducing anxiety, expediting the mental health intake and discharge process, and referring individuals to other services and community supports. This resource paper highlights some successful peer support programs initiated after recent disasters and provides recommendations for the expansion and broader integration of peer support initiatives. (National GAINS Center)|NULL|NULL|NULL|NULL|NULL|Jun 8 2007 2:33PM|0|NULL|NULL|NULL|National GAINS Center|NULL|2006|Rockville, MD|48|NULL|1|NULL|NULL|http://www.witnessjustice.org/violence/docs/peersupportissuebrief.pdf|NULL|NULL|NULL|13
26321|Different Voices: Reviewing and Revising the Politics of Working With Consumers in Mental Health|Working with consumers is now a common expectation in contemporary mental health services. Yet health professionals may not entirely understand the difference between patient and consumer roles. Alternatively, they may feel they do not have the skills or resources to deal with people in roles other than patient or carer. Nor may they be able to separate out their personal experiences with particular consumers from the ideals and goals for effective consumer partnerships. This paper reviews a concept known as the politics of difference as well as the rise of the consumer movement in order to explore areas of difference between consumers and providers, to reexamine how power and marginalization practices occur. It reminds professionals that generalizing from one failed experience relating with a consumer is just as invalid as idealizing the current policy of consumer inclusion. Inviting, allowing, amplifying and improving the effectiveness of the consumer voice in mental health services today requires active commitment, educative processes and novel strategies to move beyond superficial relationships so that consumers and professionals work together to make enduring change. (Authors)|1|13|International Journal of Mental Health Nursing|22-32|NULL|Jun 8 2007 3:02PM|1|NULL|NULL|McAllister, Margaret;Walsh, Kenneth;|NULL|NULL|2004|NULL|48|NULL|1|NULL|NULL|http://onlinelibrary.wiley.com/|[email protected]|NULL|NULL|6
26323|The Next Wave: Employing People With Multiple Barriers To Work: Policy Lessons From the Next Step: Jobs Initiative and the Next Wave Symposium|Supportive Housing is affordable housing integrated with voluntary social and supportive services. It is a solution to homelessness and an alternative to institutionalization. Next Step: Jobs (NSJ) was a three-year employment demonstration program that was designed to explore the feasibility of employment services based in supportive housing residences. Since it was formed in 1991, the Corporation for Supportive Housing (CSH) has worked in partnership with government, philanthropy and nonprofit supportive housing organizations to integrate social services and affordable housing as a solution to homelessness. Supportive housing offers affordable, permanent housing, in the community, with a web of supports provided by on-site case managers, community organizers, substance addiction counselors and other social services staff. These staff work with tenants, individually and collectively, to build a community culture that promotes residential stability and opportunities to progress. As a national intermediary with support from over 100 foundations, CSH provides funding , information, advocacy tools,and hands-on assistance to nonprofits working to increase the quantity and quality of supportive housing in eight local sites around the country. CSH also works in partnership with local, state, and federal governments to support innovative housing and service programs. To date, CSH has directly supported the development of more than 9,000 new units of supportive housing. (Authors)||||||Jun 8 2007 3:47PM|0|||Fleischer, Wendy; Sherwood, Kay; |Corporation for Supportive Housing (CSH)||2000|New York, NY|48||1|NULL|NULL|http://www2.csh.org/html/nextwave-final.pdf||212-986-6552|NULL|13
26324|Consumer-Delivered Services as a Best Practice in Mental Health Care Delivery and the Development of Practice Guidelines|Consumer-delivered services are receiving increasing attention as an important addition to the continuum of services available to people with a mental illness. This article provides a review of the theoretical and empirical evidence in support of consumer-delivered services as a best practice in mental health service delivery. This is followed by the presentation of proposed guidelines for delivering these types of services that is based on the current literature and the consensus of program directors from the Mental Health Association of Southeastern Pennsylvania, an agency that administers a number of consumer-delivered service programs. These guidelines are intended to assist in the adoption, development, and operation of consumer-delivered services and to aid policymakers and providers in their funding and referral decisions. (Authors)|3|6|Psychiatric Rehabilitation Skills|355-383|NULL|Jun 11 2007 9:10AM|0|NULL|NULL|Salzer, Mark;|Mental Health Association of Southern Pennsylvania Best Practices Team|NULL|2002|NULL|48|NULL|1|NULL|NULL|http://www.cdsdirectory.org/SalzeretalBPPS2002.pdf|NULL|NULL|NULL|6
26325|Best Practice Guidelines for Consumer-Delivered Services|Consumer-Delivered Services (CDS) have become increasingly integrated into formal mental health systems and are viewed as an important approach to expanding the continuum of services available to persons with mental illness, including those with serious mental illness. Many definitions of “consumer” exist. For our purposes we define a consumer as someone who has experienced, or is currently experiencing, symptoms associated with a diagnosable mental illness, and has received services to address these symptoms. CDS are those services where identified consumers interact with other identified consumers in services that are uniquely consumer-delivered (e.g., self-help groups) or as part of services that involve both consumer and non-consumer staff (e.g., case management). We believe that the sharing of personal experience is a critical element of CDS and is part of what make them beneficial. It is recognized that many professionals have personal experiences with mental illnesses but choose not to identify as mental health consumers and do not share their personal experiences as consumers. Services delivered by persons who do not identify as consumers or share their personal experiences as consumers are not CDS. A program or agency where consumers serve only as advisers or on a board is not a CDS. (Authors)|NULL|NULL|NULL|NULL|NULL|Jun 11 2007 9:13AM|0|NULL|NULL|Salzer, Mark;|Behavioral Health Recovery Management Project (BHRM)|NULL|2002|Peoria, IL|48|NULL|1|NULL|NULL|http://www.bhrm.org/guidelines/salzer.pdf|NULL|NULL|NULL|13
26326|Is Social Work's Door Open To People Recovering From Psychiatric Disabilities?|Social workers are the major providers of mental health services in the United States, yet the profession has been reluctant to include recovering consumers in its ranks. This article contrasts social work's historic focus on the deficits believed to be inherent in colleagues' history of psychiatric disorder with an empowerment perspective. The article describes perceived risks and benefits to clients when the social worker has a history of a psychiatric disorder. It reviews recovering consumers' successful roles as paraprofessionals in mental health services delivery as a demonstration of the strengths consumers bring to the mental health field. Finally, it identifies barriers to social work employment faced by the social worker who has a history of a psychiatric disability. (Author)|1|47|Social Work|75-83||Jun 11 2007 9:17AM|1|||Stromwall, Layne; |||2002||48||1|NULL|NULL|http://www.ncbi.nlm.nih.gov/pubmed/11829247|[email protected]||NULL|6
26330|The Kansas Consumer As Provider Program: Measuring the Effects of a Supported Education Initiative|Consumers providing direct services at mental health centers contribute positive qualities to the service delivery system; however, there are few instructional programs to prepare consumers for these roles. Of the few consumer-provider training programs that exist, those conducting research have focused on employment and hospitalization outcomes. No program has researched changes in students' perceptions of subjective well-being. Research with students in the Kansas Consumer as Provider (CAP) training program found significant differences in students' perception of hope, self-esteem, and recovery after the training program. (Authors)|3|29|Psychiatric Rehabilitation Journal|174 - 182||Jun 11 2007 12:29PM|1|||Ratzlaff, Sarah; McDiarmid, Diane; Marty, Doug; Rapp, Charles; |||2006||48||1|NULL|NULL|http://www.ncbi.nlm.nih.gov/pubmed/16450928|[email protected]|785-856-2880|NULL|6
26332|Strengthening the Consumer Voice in Managed Care: VII The Georgia Peer Specialist Program|The state of Georgia has pioneered a certified peer specialist program that combines consumer-provided services, consumer advocacy, and consumer influence on policy in a highly innovative manner. In this column, the seventh in a series on strengthening the consumer voice in managed care (5–10), we present lessons about enhancing the consumer role derived from Georgia’s unique program. Although Georgia’s program is currently one of a kind, the values and strategy that inform the program could have wide application. (Authors)|4|54|Psychiatric Services|497-498||Jun 11 2007 12:48PM|0|||Sabin, James; Daniels, Norman; |||2003||48||1|NULL|NULL|http://www.hawaii.edu/hivandaids/Strengthening_the_Consumer_Voice_in_Man...|[email protected]||NULL|6
26335|Hiring Consumer-Providers: Barriers and Alternative Solutions|The hiring of consumers as providers of mental health services has steadily increased over the last decade. This article, based on the literature and two round table discussions, explores three prevalent barriers (i.e., dual relationships, role conflict, and confidentiality) and proposes alternative solutions to each. (Authors)|3|37|Community Mental Health Journal|199-213|NULL|Jun 11 2007 1:16PM|1|NULL|NULL|Carlson, Linda;Rapp, Charles;McDiarmid, Diane;|NULL|NULL|2001|NULL|48|NULL|1|NULL|NULL|http://link.springer.com/|NULL|NULL|NULL|6
26336|Consumers As Providers of Mental Health Services: A Literature Review & Summary of Strategies To Address Barriers|Throughout the process of reviewing the literature, talking with administrators, supervisors, and consumer-providers, and conducting the forums, four main themes emerge: 1. There are definitely strategies available to overcome the barriers presented to professionals and consumer-provides. The Consumer-Provider Forum was particularly helpful in identifying, even for the most overwhelming obstacles, strategies that could work. Three of the most powerful barriers included dual-relationships, confidentiality, and stigma. Chapter 3 outlines all of the strategies for each of the barriers identified. 2. Other fields such as addictions and welfare have used consumers as providers. In fact, many mental health centers in Kansas that have alcohol and drug treatment programs have hired “recovering” persons who are or have been involved in services in the programs in which 7 they work. However, in mental health – particularly when thinking about people with major psychiatric disabilities, it appears that the barriers and fears around dual relationships and confidentiality are rooted in the long history of services provided under the medical model. If other provider fields in social services have been able to effectively use consumers as providers, the mental health field can certainly do so. 3. If there are to be significant increases in the Kansas State mental health system with the hiring of consumers as providers, state policy must initiate this change. The State Department of Mental Health and Developmental Disabilities, the State Association for Community Mental Health Centers, and the Consortium needs to provide a policy statement that supports consumer as providers in Community Mental Health Centers. These entities also need to develop a statewide policy on consumer-providers in mental health, including consensus on how to handle dual relationships and role conflicts for consumer-providers. There needs to be sanctioning from SRS and the Behavioral Sciences Regulatory Board (BSRB) of hiring consumer-providers, even if they have received services at that center. 4. The organizational culture of the mental health center is key to the success of consumers working as providers within the mental health system. In order for the successful integration of consumers into the provider system to occur, mental health agencies must adapt their organization to support this initiative. The nature of the organizational environment, both in the literature and the forums, was identified as critical to success. An agency that is open, flexible, values diversity, views clients as competent and significant contributors, and includes consumers in decision making are just a few of the attributes that lead to an organizational culture that supports consumers as providers. See chapter 1 (Review of the Literature) and chapter 3 (Challenges and Strategies) for more details. (Authors)||||||Jun 11 2007 1:28PM|0|||Carlson, Linda; McDiarmid, Diane; |University of Kansas School of Social Welfare||1999|Lawrence, KS|48||1|NULL|NULL||||NULL|13
26338|Effective Methods for Involving Consumers in Planning and Decision-making|In 1994, James Bell Associates was awarded a contract by the U.S. Department of Health and Human Services, Administration for Children and Families, to study the implementation of the Family Preservation and Family Support (FP/FS) services program. The purpose of the study is to examine how states and communities chose to implement the 1993 legislation creating the FP/FS program and the subsequent expansion of the program under the Adoption and Safe Families Act of 1997 (ASFA). The major study activities were in-depth case studies of 15 states and 20 localities within these states, and an annual review of the 50 state FP/FS Five-Year Plans and Annual Progress and Services Reports. Areas examined in the Implementation Study include planning and decision-making processes, funding allocations, program models of service delivery, collaborative arrangements and consumer involvement. The study also focused on the relationship between the child welfare agency, especially front-line staff, and the newly funded FP/FS programs. To supplement the individual case studies and the synthesis reports, a series of issue papers addressing topics of special interest are being developed. In the course of this study, states and communities faced many challenges and found innovative approaches to implementing new programs. These papers are focused on lessons learned from their experiences that are applicable to a broad range of family services implementation efforts. The focus of this particular paper is especially effective models for involving consumers in planning and decision-making. (HHS)|NULL|NULL|NULL|NULL|NULL|Jun 11 2007 1:47PM|0|NULL|NULL|NULL|U.S. Department of Health and Human Services (HHS): Administration for Children & Families|NULL|NULL|Washington, D.C.|48|NULL|1|NULL|NULL|http://www.acf.hhs.gov/programs/opre/resource/effective-methods-for-invo...|NULL|NULL|NULL|13
26339|Case Study: Chicago Health Outreach|Chicago Health Outreach (CHO) is a community health organization providing physical health, mental health, and support services to the city’s neediest citizens - individuals who are homeless, mentally ill, refugees and immigrants - regardless of their ability to pay. CHO was founded in 1985 as a homeless demonstration project funded by the Robert Wood Johnson Foundation. CHO began providing medical care for HIV positive individuals four years later. At that time, most community health organizations in Chicago referred HIV positive clients to the county hospital. CHO, on the other hand, took the approach of providing integrated HIV care with other medical services in the community and subsequently became one of the original Title III programs in the city serving the largest number of individuals living with HIV/AIDS in Chicago. CHO is part of Heartland Alliance for Human Needs & Human Rights, a larger non-profit organization with several separately incorporated non-profit subsidiaries. Chicago Connections, another Heartland Alliance subsidiary, provides human services, and Century Place Development Corporation provides supported housing services. The three organizations work together closely to provide services for HIV positive substance users and are described together in the case study below. Approximately 10% of CHO’s 11,000 clients are HIV positive; nearly all of these individuals have a recent history of substance abuse. More than 50% of their HIV clients are African American, 25% are White, 12% are Hispanic, and the remainder are of other racial/ethnic backgrounds. Approximately 60% of their HIV-positive clients receive Medicaid benefits, but almost 40% are uninsured. A serious challenge for CHO and other providers serving the uninsured is limited substance abuse residential treatment. There are only five slots reserved for uninsured homeless individuals in Chicago. CHO became a federally-funded community health center in 2000, enabling the organization to maximize federal funds and Medicaid dollars as a Federally Qualified Health Center. CHO has developed relations with several managed care organizations, since from the consumer’s perspective, managed care plans provide a source of payment for their medications. The majority of CHO staff are grant-funded, offering services to the uninsured and those with Medicaid benefits who need services that Medicaid does not pay for. (Health & Disability Working Group)|NULL|NULL|NULL|NULL|NULL|Jun 11 2007 2:10PM|0|NULL|NULL|NULL|Health & Disability Working Group, Boston University School of Public Health|NULL|NULL|Boston, MA|48|NULL|1|NULL|NULL|http://www.bu.edu/hdwg/pdf/projects/trainingfiles/ChicagoHealthOutreach.pdf|[email protected]|773-751-1736|NULL|13
26340|On the Road To Collaborative Treatment Planning: Consumer and Provider Perspectives|Although consumers have made significant gains in having their voices heard in several areas within the mental health, they have made less progress in being able to collaborate with their own treaters in setting treatment goals. On the basis of several years of groundwork by staff at the Connecticut Mental Health Center (CMHC), the Patient Care Committee conducted a n eds assessment of providers and consumers to assess both groups' current involvement, interest in, and attitudes toward collaborative treatment planning. The results indicate that providers tend to place much of the responsibility for the difficulties in implementing collaborative treatment planning on consumers. Also, providers tend to underestimate consumers; interest in participating in this process. Implications of these findings for the development of an agency-wide training to enhance the collaborative nature of treatment planning are discussed. (Authors)|2|26|Journal of Behavioral Health Science & Research|211-218||Jun 11 2007 2:12PM|1|||Chinman, Matthew; Allende, Marge; Weingarten, Richard; Steiner, Jeanne; Tworkowski, Sophie; Davidson, Larry; |||1999||48||1|NULL|NULL|http://www.ncbi.nlm.nih.gov/pubmed/10230148|[email protected]||NULL|6
26341|Peer Support Among Adults With Serious Mental Illness: A Report From the Field|Peer support is based on the belief that people who have faced, endured, and overcome adversity can offer useful support, encouragement, hope, and perhaps mentorship to others facing similar situations. While this belief is well accepted for many conditions, such as addiction, trauma, or cancer, stigma and stereotypes about mental illness have impeded attempts on the part of people in recovery to offer such supports within the mental health system. Beginning in the early 1990s with programs that deployed people with mental illness to provide conventional services such as case management, opportunities for the provision and receipt of peer support within the mental health system have proliferated rapidly across the country as part of the emerging recovery movement. This article defines peer support as a form of mental health care and reviews data from 4 randomized controlled trials, which demonstrated few differences between the outcomes of conventional care when provided by peers versus non-peers. We then consider what, if any, unique contributions can be made by virtue of a person's history of serious mental illness and recovery and review beginning efforts to identify and evaluate these potential valued-added components of care. We conclude by suggesting that peer support is still early in its development as a form of mental health service provision and encourage further exploration and evaluation of this promising, if yet unproven, practice. (Authors)|NULL|NULL|Schizophrenia Bulletin|1-8|NULL|Jun 11 2007 2:15PM|0|NULL|NULL|Davidson, Larry;Chinman, Matthew;Sells, David;Rowe, Michael;|NULL|NULL|2006|NULL|48|NULL|1|NULL|NULL|http://schizophreniabulletin.oxfordjournals.org/content/early/2006/02/03...|[email protected]|NULL|NULL|6
26343|The Effectiveness of Service User-Run or Service User-Led Mental Health Services for People With Mental Illness|The main objective of this report is to systematically identify and appraise the international evidence for the effectiveness of service user-run or service user-led mental health services for people with mental disorders. A service user-run, service is defined as a program, project, or service planned, administered, delivered, and evaluated by a server user group based on needs defined by the service user group. Operation of the service requires self-governance by service users themselves, service users staffing and supervision of this staff, service user control of program policy, and service user responsibility for program implementation. This report seeks to highlight the potential for investment in, and future evaluation of, service user-run initiatives and services within the mental health sector. This report is divided into sections that describe background, methodology (search strategy, inclusion, and exclusion criteria, and outcomes considered), results (primary and secondary research included) Results include tables outlining the best available evidence, which present each appraised study's methods, results, limitations, and authors' conclusions. The final section summaries results, briefly discusses methodological limitations in the area, and presents key conclusions. (Authors)||||||Jun 11 2007 2:28PM|0|||Doughty, Carolyn; Tse, Samson; |Mental Health Comission||2005|Wellington, New Zealand|48||1|NULL|NULL|http://www.mhc.govt.nz/publications/effectiveness-service-user-run-or-se...|[email protected]||NULL|13
26344|Mixing Qualitative Methods: Quality Assurance Or Qualitative Quagmire?|Although the advisability of combining qualitative and quantitative approaches has been questioned on the grounds of incompatibility of epistemological assumptions that underpin the two paradigms, mixing methods within the qualitative paradigm has been viewed as a more straightforward enterprise. This article challenges this view, highlighting the existence of several qualitative traditions, each with its own distinctive set of assumptions about what constitutes appropriate research questions; theoretical frameworks; research settings; relationships with those whom we study; techniques for eliciting data; form and content of data; and approaches to analyzing, presenting, and disseminating data. Multimethod qualitative approaches can be seen to occupy a contested domain. Analytical rigor would be strengthened by acknowledging and addressing the potentially contradictory assumptions on which one draws when seeking to combine qualitative methods. As qualitative researchers, it is incumbent on us to pay attention to context—not just in terms of the data collected but in terms of our own methodological positions. (Authors)|3|8|Qualitative Health Research|352-361||Jun 12 2007 1:14PM|1|NULL|NULL|Barbour, Rosaline ;|||1998||48||0|NULL|NULL|http://qhr.sagepub.com/content/8/3/352.abstract|||NULL|6
26345|From Practice To Research: the Case for Criticism in An Age of Evidence|The growth in research and in health care costs has made it important for clinicians to use and critically appraise published evidence for their medical decisions. The evidence-based medicine movement is an example of the present effort to teach clinicians to evaluate research evidence by methodologic standards. Though this effort can only improve the clinical decisions of practitioners, it suggests that when assessing evidence there are no reasons to critically evaluate the standards of research and evidence themselves. A precedent for assessing standards of research and evidence exists in the broad tradition known as criticism. Using contextual, cultural and other forms of analysis, writers have used criticism to show that the meaning and validity of scientific evidence is influenced as much by the sociocultural characteristics of readers and users as it is by the meticulous use of research methods. Scholars outside of medicine have suggested, for example, that data become evidence only in the context of specific beliefs and disagreements and that there are interesting pragmatic reasons why we see some forms of evidence and not others in the medical literature. Social critical studies of research and evidence would reveal the many influences similar to these that are relevant to clinical medicine. The effort would be practically useful to physicians, who with a broader understanding of research could critically appraise published evidence from both scientific and sociocultural perspectives. It would also help correct an imbalance in contemporary medicine in which clinicians are being trained to maintain high standards of critical consciousness in methodological domains but not in the broader historical and sociocultural domains which subsume them. (Author)|10|47|Social Science and Medicine|1539-1545||Jun 12 2007 1:19PM|1|NULL|NULL|Berkwits, Michael;|||1998||48||0|NULL|NULL|http://linkinghub.elsevier.com/retrieve/pii/S0277953698002329?via=sd&cc=y|||NULL|6
26346|Cochrane Or Cock-eyed? How Should We Conduct Systematic Reviews of Qualitative Research?|The quantitative versus qualitative debate has taken significant steps towards reconciliation within the wider field of evidence based practice. Nevertheless, far more insidious discrimination remains. Systematic review methodology exhibits all the characteristics of institutionalized quantitativism in that criteria for a good review are almost entirely determined by the quantitative methods promoted and perpetuated by the Cochrane Collaboration. Nobody who understands qualitative research would insist that its primary studies demonstrate alien concepts such as sample size or statistical power. Yet comparably fundamental absurdities persist with regard to qualitative syntheses. Why should systematic reviewers of qualitative research pursue a gold standard comprehensive literature search when concepts such as data saturation have an established pedigree? Why should they apologize for an absence of meta-analysis when little-known techniques such as meta-ethnography could be included in a reviewer's toolbox? Why shouldn't they apply systematic, explicit and reproducible principles of thematic or concept analysis to create syntheses that advance our understanding of qualitative issues and highlight research gaps? The author draws on experience of a dozen systematic reviews, a third qualitative, to suggest how systematic reviews of qualitative research might acquire a methodology that is more sympathetic to the paradigm within which they are conducted. (Author)||||||Jun 12 2007 1:26PM|0|NULL|NULL|Booth, Andrew;|Qualitative Evidence-based Practice Conference: Taking a Critical Stance||2001|NULL|48||0|NULL|NULL|http://www.leeds.ac.uk/educol/documents/00001724.doc|||NULL|20
26347|Quality and Quantity in Social Research|This book provides the student with a concise account of the debate about the nature and comparative values of quantitative and qualitative research methods. (Authors)||||||Jun 12 2007 1:37PM|1|NULL|NULL|Bryman, Alan;|||1988|London, England|48||0|NULL|NULL|http://www.amazon.co.uk/Quantity-Quality-Social-Research-Contemporary/dp...|||NULL|10
26348|Evaluating the Level of Evidence of Qualitative Research|Guidelines for evaluating the levels of evidence based on quantitative research are well established. However, the same cannot be said for the evaluation of qualitative research. This article discusses a process members of an evidence-based clinical practice guideline development team with the Association of Women's Health, Obstetric and Neonatal Nurses used to create a scoring system to determine the strength of qualitative research evidence. A brief history of evidence-based clinical practice guideline development is provided, followed by discussion of the development of the Nursing Management of the Second Stage of Labor evidence-based clinical practice guideline. The development of the qualitative scoring system is explicated, and implications for nursing are proposed. (Authors)|6|31|Journal of Obstetric, Gynecologic, & Neonatal Nursing|708-714||Jun 12 2007 1:40PM|1|NULL|NULL|Cesario, Sandra;Morin, Karen;Santa-Donato, Anne;|||2002||48||0|NULL|NULL|http://onlinelibrary.wiley.com/|||NULL|6
26349|On the Idea of What Constitutes Good Qualitative Inquiry|no abstract available|2|11|Qualitative Health Research|504 - 510||Jun 12 2007 1:53PM|1|NULL|NULL|Engel, John;Kuzel, Anton;|||1992||48||0|NULL|NULL|http://qhr.sagepub.com/content/2/4/504.citation|||NULL|6
26350|Qualitative Research and Evidence Based Medicine|Qualitative research may seem unscientific and anecdotal to many medical scientists. However, as the critics of evidence based medicine are quick to point out, medicine itself is more than the application of scientific rules. Clinical experience, based on personal observation, reflection, and judgment, is also needed to translate scientific results into treatment of individual patients. Personal experience is often characterized as being anecdotal, ungeneralisable, and a poor basis for making scientific decisions. However, it is often a more powerful persuader than scientific publication in changing clinical practice, as illustrated by the occasional series A patient who changed my practice in the BMJ. In an attempt to widen the scope of evidence based medicine, recent workshops have included units on other subjects, including economic analysis and qualitative research. However, to do so is to move beyond the discipline of clinical epidemiology that underpins evidence based medicine. Qualitative research, in particular, addresses research questions that are different from those considered by clinical epidemiology. Qualitative research can investigate practitioners' and patients' attitudes, beliefs, and preferences, and the whole question of how evidence is turned into practice. The value of qualitative methods lies in their ability to pursue systematically the kinds of research questions that are not easily answerable by experimental methods. We use the example of asthma treatment to illustrate how qualitative methods can broaden the scope of evidence based medicine. Although there is consensus over evidence based practice in the treatment of asthma, questions remain about general practitioners' use of clinical guidelines and patients' use of prescribed medication.||316|British Medical Journal|1230-1232||Jun 12 2007 1:59PM|0|NULL|NULL|Green, Judith;Britten, Nicky;|||1998||48||0|NULL|NULL|http://www.bmj.com/content/316/7139/1230|[email protected]||NULL|6
26351|Appraising the Evidence: Reviewing Disparate Data Systematically|The authors describe a method of systematically reviewing research from different paradigms. They draw on the methods adapted, developed, and designed during a study concerned with the delivery of care across professional boundaries. Informed by the established method of systematic review, the authors undertook the review in distinct stages. They describe the methods developed for each stage and outline the difficulties encountered, the solutions devised, and the appraisal tools developed. Although many of the problems encountered were related to the critical assessment of qualitative research, the authors argue that the method of systematic review can be adapted for use with different data and across disciplines. (Authors)|9|12|Qualitative Health Research|1284-1299||Jun 12 2007 2:08PM|1|NULL|NULL|Hawker, Sheila;Payne, Sheila;Kerr, Christine;Hardey, Michael;Powell, Jackie;|||2002||48||0|NULL|NULL|http://qhr.sagepub.com/content/12/9/1284.abstract|||NULL|6
26352|Qualitative Research and Evidence-Based Healthcare|We seek to address three issues. First, we want briefly to highlight some limitations of the EBM movement identified by social scientists. Second, we wish to explore the implications of the apparent shift away from a focus on medicine towards healthcare for the nature of the evidence which can legitimately be used. Finally, we consider some of the Nways in which qualitative research can contribute to this broader agenda and point to some of the constraints on the achievement of this potential. (Authors)|35|91|Journal of the Royal Society of Medicine|32-37||Jun 12 2007 2:15PM|0|NULL|NULL|Popay, Jennie;Williams, Gareth;|||1997||48||0|NULL|NULL|http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1296362/pdf/jrsocmed00015-00...|||NULL|6
26353|Mixed Methodology: Combining Qualitative and Quantitative Approaches|Mixed Methodology explains the differences between using mixed methods in only the research methodology portion of a study versus using mixed model studies across all phases of the research process, and then presents a typology of mixed methods and mixed model studies. (Authors)||||||Jun 12 2007 2:24PM|1|||Tashakkori , Abbas; Teddlie, Charles; |||1998|Thousand Oaks, CA|48||0|NULL|NULL|http://www.sagepub.com/books/Book6245|||NULL|10
26354|When is Evidence Sufficient?|Traditional conceptualizations of evidence-based medicine rely heavily on randomized controlled trials. Although initiatives to broaden definitions of evidence have been advanced, they generally have not tied evidentiary criteria formally and quantitatively to the benefits and costs involved in a decision to adopt or reject an intervention. Decision analysis provides a framework for combining information to inform the adoption decision in this manner. Value-of-information analysis, a related methodology, helps to determine whether it is worthwhile to collect additional information as well as the type of research that would be most helpful. (Authors)|1|24|Health Affairs|93-101||Jun 13 2007 9:01AM|1|NULL|NULL|Claxton, Karl;Cohen, Joshua;Neumann, Peter;|||2005||48||0|NULL|NULL|http://content.healthaffairs.org/content/24/1/93.abstract|||NULL|6
26355|Evidence-Based Practices in Mental Health: Debate and Dialogue on the Fundamental Questions|Few topics in mental health are as important and controversial as evidence-based practices. EBPs have profound implications for mental health practice, training, and policy. What is designated as evidence-based will determine in part what therapies and tests are conducted, what is reimbursed, what is taught, and what is researched. Unfortunately, this multifaceted topic has been reduced to simplistic and polarized arguments. This book, designed for mental health practitioners, trainers, and graduate students, addresses nine fundamental questions in the debate on evidence-based practices (EBPs). Each chapter centers on one particular question in the ongoing debate and consists of focused position papers on that question. The position papers, contributed by the some of the most respected psychologists writing today, are argued with passion and intelligence. Each chapter concludes with a dialogue among the contributors in which they emphasize their points of agreement and disagreement. This makes the book an ideal tool for teaching and discussion. This book helps readers understand the central questions in this fiercely contested subject, provides a balance of views, and purges needless confusion and antagonism. In doing so, the book underscores both the robust commonalities and the remaining contentions regarding evidence-based practices in mental health. (APA.org)||||||Jun 13 2007 9:45AM|1|NULL|NULL|NULL|||2005|Washington, D.C.|48||0|NULL|NULL|http://www.apa.org/pubs/books/4317087.aspx|||NULL|10
26356|Evidence-based Medicine: A Unified Approach|Behind the wide acceptance of the idea of evidence-based medicine are two curious facts: There are two very different approaches to applying evidence to medicine, and the most commonly cited definition applies to only one of them. This paper describes the problem that we are asking evidence to solve and the different methods by which evidence can be used to help solve that problem, and recommends a unified approach. (Authors)|1|24|Health Affairs|9-17||Jun 13 2007 9:57AM|1|NULL|NULL|Eddy, David;|||2005||48||0|NULL|NULL|http://content.healthaffairs.org/content/24/1/9.abstract|||NULL|6
26357|Modified Therapeutic Community for Homeless MICA Individuals: A Treatment manual (revised)|NULL|NULL|NULL|NULL|NULL|NULL|Jun 14 2007 10:29AM|1|NULL|NULL|NULL|NULL|NULL|1998|New York, NY|48|NULL|0|NULL|NULL|NULL|NULL|NULL|NULL|10
26358|Creating An Environment of Quality Through Evidence-Based Practices|The New York State Office of Mental Health (OMH) has embraced the 'winds of change' sweeping the nation-a renewed focus on quality, based on evidence-based treatments and practices as the foundation of structural and clinical work. OMH has pledged to promote and enact positive changes for the current system of care to reflect a continued commitment to ensuring the highest quality and most effective mental health services possible. Consistent with the foundation of the OMH Strategic Statement, the Evidence-Based Practices initiative seeks to improve the ABCs of mental health care, which include accountability for results, best practices, and coordination of services and programs throughout the mental health system in New York State. The OMH Progress Report series documents the results of our efforts to promote the ABCs of mental health care and implementation of Evidence-Based Practices. (Authors)||||||Jun 14 2007 10:39AM|0||||New York State Office of Mental Health||2005|New York, NY|48||0|NULL|NULL|http://www.omh.ny.gov/omhweb|||NULL|13
26363|Community-Wide Strategies for Preventing Homelessness: Recent Evidence|This article summarizes the findings of a study of community-wide strategies for preventing homelessness among families and single adults with serious mental illness, conducted for the US Department of Housing and Urban Development. The study involved six communities, of which this article focuses on five. A major finding of this study was that it was difficult to identify sites with community-wide strategies, and even harder to find any that maintained data capable of documenting prevention success. However, the five communities selected for this study presented key elements of successful strategies including mechanisms for accurate targeting, a high level of jurisdictional commitment, significant mainstream agency involvement, and mechanisms for continuous system improvement. (Authors)|3-4|28|The Journal of Primary Prevention|213-228||Jun 15 2007 12:49PM|0|||Burt, Martha R.; Pearson, Carol; Montgomery, Ann; |||2007||48||0|NULL|NULL|http://www.ncbi.nlm.nih.gov/pubmed/17558555|[email protected]||NULL|6
26366|Recognizing Work as a Priority in Preventing or Ending Homelessness|The literature speaks to the importance of employment in the lives of homeless individuals and shows how they can be assisted in job seeking (Long & Amendolia, 2003; Marrone, 2005; Quimby, Drake, & Becker, 2001; Rio, Russell, Dudasik, & Gravino, 1999; Rog & Holupka, 1998; Shaheen, Williams, & Dennis, 2003; Trutko, Barnow, Beck, Min, & Isbell, 1998). Some reports suggest it may be effective and worthwhile to offer employment at the earliest stages of engagement to help people who are homeless develop trust, motivation, and hope (Cook et al., 2001; Min, Wong, & Rothbard, 2004). Practitioners have historically focused on providing people with access to safe and affordable housing and supportive services, usually addressing employment later in the continuum. This practice-oriented report from the field proposes that employment should be offered as early as possible and maintains that facilitating employment is an unrecognized and underutilized practice for preventing and ending homelessness. The paper provides principles, practices, and strategies programs can use to make work a priority. (Authors)||Published Online 6/5/2007|The Journal of Primary Prevention|||Jun 15 2007 12:59PM|0|||Shaheen, Gary; Rio, John; |||2007||48||0|NULL|NULL|http://link.springer.com/article/10.1007/s10935-007-0097-5|[email protected]||NULL|6
26370|Promoting Children’s Mental Health in Family Supportive Housing: A Community-University Partnership for Formerly Homeless Children and Families|Emerging research indicates that significant numbers of formerly homeless families residing in permanent supportive housing have caregivers with substance use and mental health disorders, and children with histories of exposure to violence, abuse, and out-of-home placement. These factors place children at risk for adverse psychosocial outcomes, including later homelessness, providing a strong rationale for embedding child-focused prevention and intervention services in supportive housing contexts. This article describes a developing community–university partnership whose goal is to advance practice and research in the adaptation and dissemination of mental health prevention and early intervention for children in supportive housing. (Authors)||Published Online 6/5/2007|The Journal of Primary Prevention||Promoting Children’s Mental Health in Family Supportive Housing: A Community-University Partnership for Formerly Homeless Children and Families|Jun 15 2007 1:22PM|0|||Gewirtz, Abigail H. ; |||2007||48||0|NULL|NULL|http://s3.amazonaws.com/fshc_production/media_uploads/67/JPP_final.pdf|||NULL|6
26372|Communicating in a Crisis: Risk Communication Guidelines for Public Officials|The tragedies of September 11th, 2001 and the emerging threat of bioterrorism have reemphasized the need for public officials to communicate effectively with the public and the media to deliver messages that inform without frightening and educate without provoking alarm. The purpose of this premier is to is to provide a resource for public officials on the basic tenets of effective communication generally and working with the news media specifically. This premier is not and encyclopedia in nature, but rather and easy-to-use pocket guide on the basic skills and techniques needed for clear and effective communications, information dissemination, and message delivery. Its content focuses on providing officials withe brief orientation and perspective on the media and how they think and work, and on the public as the end-recipient of information; concise presentation of techniques for respondent to and and cooperating with the media in conveying information and delivery messages, before, during , and after a public health crisis; a practical guide to the tools of the trade of media relations and public communication; and strategies and tactics for addressing the probable opportunities and the possible challenges that are likely to arise as a consequences of such communication initiatives. (HHS)|NULL|NULL|NULL|NULL|NULL|Jun 18 2007 10:56AM|0|NULL|NULL|NULL|U.S Department of Health and Human Services (HHS)|NULL|2002|Washington, D.C.|48|NULL|1|NULL|NULL|http://store.samhsa.gov/product/SMA02-3641|NULL|NULL|NULL|14
26374|Helping Yourself Heal: A Recovering Woman's Guide to Coping with Childhood Abuse Issues|Now that you're in treatment for substance abuse you may begin to have many different feelings. At times, these feelings may be painful, and you may have a hard time understanding or coping with then you may feel: fearful, helpless, guilty, ashamed, anxious depressed, angry, bad about yourself, as if you can't connect with family and friends, as if you are crazy, numbness or nothing at all, as if you want to die. Some of these feelings are common for any woman who starts treatment for substance abuse, but the same feelings may be stronger for many women who were based in childhood. The pain may be so great that a woman many fo anything to cope with her feelings, including using drugs or alcohol. Some women in treatment for substance abuse don't clearly remember being abuse,but they have some of the feelings mentioned here. Some women may have pushed the memories of the abuse so far away that they may not be able to explain why they feel intense anger, fear a particular person, have nightmares, or always believe something bad is about to happen. Sometimes, after people stop drinking or using drugs and are in treatment, memories may surface that were to painful to remember before or that were blocked from memory by drugs and alcohol. (SAMHSA)||||||Jun 18 2007 11:13AM|0||||U.S. Department of Health and Human Services (HHS), Substance Abuse and Mental Health Administration (SAMHSA)|(SMA) 06-4132|2006|Rockville, MD|48||1|NULL|NULL|http://store.samhsa.gov/product/Helping-Yourself-Heal-A-Recovering-Woman...||800-729-6686|NULL|14
26376|Oasis: An International Learning Center for Clincians, Researchers, and Educators Engaging in MBSR and other Mindfulness-Based Approaches and Interventions|Established in 1995, the Center for Mindfulness (CFM) is an outgrowth of the acclaimed Stress Reduction Clinic, the oldest and largest academic medical center-based stress reduction program in the world. The CFM is a multi-dimensional center in the Division of Preventative and Behavioral Medicine, within the Department of Medicine at the University of Massachusetts Medical School. Since 1979, when the stress reduction clinic was founded by Jon Kabat-Zinn, PhD, we have been a leader in mindbody medicine, pioneering the integration of mindfulnesses-based practices into mainstream medicine through patient care, research, medical and professional Education, and to the larger society through a broad range of outreach and public service initiatives. As the originators of Mindfulness-Based Stress Reductions (MBSR) our foremost priorities in the domain of Professional Education and Training have been to: Affirm the intentional cultivation of the inner life of the professional as central to learning and teaching. Establish Standards of Practice for MBSR, Elucidate Qualification and Guidelines for MBSR teachers, Explore and begin to clarify the pedagogical principle of MBSR, Engage in the development of MBSR teachers through the deilvery of in-depth training programs, Refine and implement a comprehensive Teacher Certification process in MBSR, Instruct professional intent on utilizing core elements of MBSR in their work in fields as diverse as education, psychology, law, athletics, business, and the domain of social justice, and provide forum for clinicians and researcher of MBCT and an array of other mindfulness-based approaches to experience first hand and understand the core elements and theoretical underpinnings of MBSR. (Authors)||||||Jun 18 2007 11:39AM|0|NULL||NULL|The Center for Mindfulness in Medicine, Health Care and Society Department of Medicine||2007|Worcester, MA|48||1|NULL|NULL|http://www.umassmed.edu/customerror/errorpage.html?aspxerrorpath=/cfm/ed...||508-856-2656|NULL|26
26377|Intergrated Behavioral Health Program|A collaborative program involving the city of Austin's Federally Qualified Community Health Care Centers (CHC) and the Austin Travis County Mental Health and Mental Retardation Center (ATCMHMR). The E-Merge program intergrates behavioral health care services within the primary health care clinics in an effort to comprehensively address the needs of the patient population. The goal of the program, is to assist patients in achieving both imporved physical health and behavioral health care functioning by concurrently addressing their expressed needs. Behavioral health providers are integrated into the primary health care team in an effort to provide timely, culturally responsive, seamless and comprehensive health carte service. The behavioral health care providers utilize brief therapy approaches incorporating cognitive behavioral and/or interpersonal therapies to assist patients challenged by mild to moderate behavioral disorders and substance abuse disorders. This service model facilitates the behavioral health providers to not only meet the demands of the fast paced primary clinic setting, but to also serve more patients on a daily basis. Behavioral health services are currently being provided in twelve (12) primary health care clinics through Austin-Travis County. The behavioral health providers deliver services to adults and children in individual, group, family, and couple sessions. The majority of behavioral health consultants are be bi-lingual in Spanish and hold a masters' degrees or higher and licenses to practice in the State of Texas as a licensed Clinical Social worker, Licensed Professional Counselor, or a Licensed Marriage and Family Counselor. (Author)||||||Jun 18 2007 11:55AM|0||||Community Health Care Centers||NULL|Austin, TX|48||1|NULL|NULL|https://www.austinpcc.org/documents/specialprograms/IBH_year_3_report.pdf|||NULL|13
26378|Homeless Education: An Introduction to the Issues|People experiencing homelessness are not a static group; homelessness is a "revolving-door phenomenon:. It estimated that, over the course of a year between 2.3 and 3.5 million people will experience homelessness, of which between 900,000 and 1.4 million will be children. The main cause for homelessness is the lack of affordable housing. While this lack alone is often enough to cause homelessness, when combined with other factors such as low wags, unemployment, domesitc violence, illness, mentla health issuesm,and addiction, the risk of experiencing homelessness increases dramatically. Unaccompanied youth are not in the physical custody of a parent of guardian. The primary causes of homelessness among unaccompanied youth are physical and sexual assault abuse by a parents or guardian, neglect, parental substance abuse, and family conflict. (NCHE)||||||Jun 18 2007 12:05PM|0||||National Center for Homeless Education (NCHE) at SERVE||NULL|Greensboro, NC|48||1|NULL|NULL|http://center.serve.org/nche/downloads/briefs/introduction.pdf|||NULL|31
26379|Meeting the Educational Needs of Student Displaced by Disasters: Youth on Their Own|During the course of a natural disaster or similar emergency, youth, may be separated form their parents or guardians. After the 2005 Gulf Coast hurricanes, for example, may youth were evacuated without their parents or guardians and sent to different locations, leaving the youth alone in the care of relief agencies. Other youth were on their own for a vareity of reasons before the storms and remained so afterwards. For all these youth, school can be the most stable and secure environment, offering structure and resources to help overcome the traumas they have experienced and helping to regain their academic, social, and emotional footing. Yet without a parent or guardian to advocate for them and exercise parental rights, these youth may face unique barriers to accessing education and related supports services. Fortunately, federal education law the McKinney-Vento Homeless Assistance Act (Subtitle B- Education for homeless Children and Youth), reauthorized as Title X, Part C of the No Child Left Behind Act, ensures educational protections for youth who are homeless and unaccompanied. This document explains key aspects of the law and provides strategies for implementation. (NCHE)|NULL|NULL|NULL|NULL|NULL|Jun 18 2007 12:17PM|0|NULL|NULL|NULL|National Center for Homeless Education (NCHE) at SERVE|NULL|2006|Greensboro, NC|48|NULL|1|NULL|NULL|http://center.serve.org/nche/downloads/briefs/csds_youth.pdf|[email protected]|800-308-2145|NULL|13
26380|Project GRACE:The Gainesville/Alachua County 10-Year Plan to End Homelessness Addressing Health Care in 10-Year Plans to End Homelessness|The causes of homelessness are complex, yet reoccurring themes that emerge are: poverty, lack of affordable housing and need for services. According to the most recent point-in-time survey conducted by the Alachua County Coalition for the Homeless and Hungry, the primary causes of homelessness were:unemployment, income that doe snot meet basic needs, alcohol/drug problems, mental health issues, domestic violence, physical/medical problems, released from and institution (jail, prison, hospital) and divorce/separation. Gainesville does not have a housing shortage but a lack of housing that is affordable for the people who live and work in our community. There are aslo need for permanent supportive housing for homeless persons with disabilities. Currently, we have inadequate services capacity for the needs of our homeless neighbors. The system of care is fragmented. Homeless persons have difficulty accessing mainstream resources. Poor discharge planning from public systems (hospitals, jails, etc.) results in additional homelessness. Existing ordinances, polices and programs limit law enforcement options in terms of arresting homeless person. There is a fundamental need for enhanced public awareness regrading the plight of the homeless. (Authors)||||||Jun 18 2007 12:35PM|0|||Lawrence, Sally; DeCarmine, Jon; |City of Gainesville/Alachua County Officee on Homelessness||2007|Gainesville, FL|48||1|NULL|NULL|http://www.alachuacounty.us/Depts/BOCC/Documents/[pp.1-58]GRACECOMPLETE.pdf|||NULL|13
26381|Homeless Conditions in Gainesville: Homeless Point-in-Time Census & Enumeration|The U.S Interagency Council on Homelessness had in recent years spearheaded a number of initiatives aimed at getting chronically homeless individuals off the street and into permanent housing. A chronically homeless person, according to HUD is someone who is (1) Unaccompanied (no family); (2) disabled; and (3) homeless four or more times over the past three years, or homeless for a period of time lasting longer than a year. There are over 179 individuals who meet the criteria for chronic homelessness, a decrease of 18.3 % from the count of chronically homeless individuals (219) taken during census. While a variety of reasons have impacted this tally, recent advancements by the Alachua County Housing Authority and Meridian Behavioral Healthcare in implementing a Housing First Strategy have significantly impacted this population. (Author)|NULL|NULL|NULL|NULL|NULL|Jun 18 2007 12:47PM|0|NULL|NULL|DeCarmine, Jon;|Gainesville/Alachua County Office on Homelessness and Alachua County Coalition for the Homeless & Hungry|NULL|2007|Gainesville, FL|48|NULL|1|NULL|NULL|NULL|[email protected]|352-372-2549|NULL|13
26382|Tools for helping shelters, day centers, and homeless housing sites imporve health & safety|Shelter and transitional housing programs funded by the City of Seattle must adhere to certain minimum standards, many of which relate to health and safety. The Health Care for the Homeless Network of Public Health-Seattle King County provides free technical assistance to shelters to help them understand and meet the standards. Public Health Nurses conduct assessments in shelters and develop regular trainings for shelter staff, and limited client health sessions for shelter guests. e also provide sample polices and guidelines that shelters can adopt, and use the opportunities to talk with shelters about pandemic flu planning. (Author)|NULL|NULL|NULL|NULL|NULL|Jun 18 2007 12:59PM|0|NULL|NULL|Flemming, David;|Health Care for the Homeless Network - Public Health|NULL|2007|Seattle, WA|48|NULL|1|NULL|NULL|NULL|NULL|206-296-5091|NULL|13
26383|An Influenza Pandemic Planning Guide for Homeless and Housing Service Providers|The purpose of this planning guide it to help Seattle-King County homeless service agencies-including shelters, day programs, housing programs, and others-prepare for an influenza pandemic. This planning guide: provides information on influenza, what homeless agencies can expect, and where to get more information. Outlines Public Health - Seattle & King County's (PHSKC) role during an influenza pandemic. Lays out issues if special concern for homeless service agencies on pandemic flu preparation and response, and offers initial guidance. Identifies areas for future discussion and planning. Encourages organizations to start incorporating new practices in their day-to-day operations now that will help them during an influenza pandemic or any other emergency. (HCH)||||||Jun 18 2007 1:07PM|0|||Public Health-Seattle King County; |Health Care for the Homeless Network||2006|Seattle-King County, WA|48||1|NULL|NULL|http://www.kingcounty.gov/healthservices/health/preparedness/pandemicflu...|[email protected]|206-296-5091|NULL|26
26384|Promoting Personal Safety during Outreach, Shelter and Home Visits A Technical Assistance Document|This is a technical assistance document form Public Health-Seattle & King County Health Care for the Homeless Network (HCHN). Its purpose is to provide recommendations, sample polices from other organizations, and guidance to HCHN contractors and HCHN providers that will promote safe behaviors and activities during field visits. a field visit may include a visits for the purpose of outreach and engagement of the client, or for the provision of health care services in the streets, in the community, in shelters or in homes. The document is divided into three sections: Promoting Safety: (1)Steps for employers and Employees Can Take. (2) Safety Strategies for Lone Staff on field visits and (3) Avoiding Risks to Personal Safety during Field Visits. (HCHN)||||||Jun 18 2007 1:15PM|1|||Health Care for the Homeless Clinician's Network (HCHCN); |Health Care for the Homeless Network (HCHN)||2007|Seattle, WA|48||1|NULL|NULL|http://www.docstoc.com/docs/74298919/Memorandum-of-Promting-Someone||206-296-5091|NULL|13
26385|2005 Annual Report on Homeless Deaths|This report summarizes the 2005 demographics and cause of death data from the King County Medical Examiner (KCME) on deaths of individuals identified as having been likely homeless at the time of death. In total, 94 deaths of homeless people were identified by the KCME in 2005. Because only certain deaths come under the jurisdiction of the KCME, these 94 deaths do not constitute a representative sample of all the homeless deaths. In particular, deaths dues to natural causes are not representative of all natural deaths. Certain information may also not be available nor accessible. For example, if homeless status was not known, if next of kin was present at the time of natural death and provided an address (which is a likely reason for underreporting of youth deaths), or if a person was already hospitalized for care at the time of their death, they may not be captured here. In this report, comparisons are made to the data presented in the 2004 annual report. However, since complete information on all homeless deaths is not available (as described above), these implications mus be considered cautiously. In addition, this 2005 summary should not be compared directly with the 2003 King County Homeless Death Review prepared by Health Care for the Homeless Network (HCHN). Resources allowed for a special , in-depth study for the 2003 report, and a different method was sued to identify the homeless population. Individuals in supportive housing were included in the 2003 report, and are not included here. (Authors)|NULL|NULL|NULL|NULL|NULL|Jun 18 2007 1:27PM|0|NULL|NULL|NULL|Health Care for the Homeless Network Public Health - Seattle & King County|NULL|2006|Seattle, WA|48|NULL|1|NULL|NULL|http://www.kingcounty.gov/healthservices/health.aspx|NULL|206-296-4720|NULL|13
26389|Homeless Veterans and Advocates Gather in D.C. to Address New Challenges|Pete Dougherty of thgoing collaborative efforts with HUD to plan for thee U.S. Veterans Administration also spoke during the June 5th “Focus on Public Policy Issues” session, informing the audience of the VA’s on permanent supportive housing needs of veterans. In addition, Mr. Dougherty noted that the VA has been authorized to hire 21 network-level coordinators to improve access to services for incarcerated veterans.||||||Jun 18 2007 2:25PM|0|||Paquette, Kristen; |Institute on Homelessness and Trauma||2007|Newton, MA|48||0|NULL|NULL|http://www.nchv.org/docs/Microsoft Word - Risk and Protective Factors for Homelessness among OIF Veterans.pdf|||NULL|13
26390|Women Veterans: A New Focus|Homeless women veterans have long been a priority of the National Coalition for Homeless Veterans (NCHV). They are now becoming a national priority of the U.S. Veterans Administration, as evidenced by the Special Needs grant money targeting women veterans, available in a recent Notice of Funding Availability.||||||Jun 18 2007 2:36PM|0|||U.S. Department for Veterans Affairs (VA); |U.S. Department of Veterans Affairs (VA)||2006|Washington, D.C.|48||0|NULL|NULL|http://www.womenvetsptsd.va.gov/Womens_Outpatient_Program.asp|||NULL|13
26391|Customized Employment for Homeless Veterans|The Office of Disability Employment Policy (ODEP) within the U.S. Department of Labor is committed to improving employment outcomes for individuals with disabilities. To achieve this goal, ODEP established a Customized Employment initiative to build the capacity of workforce systems to serve all customers, including individuals with disabilities. The strategies developed through this initiative can assist all workforce customers who have complex needs and may require more individual assistance to achieve their employment goals. The Customized Employment initiative also focuses on using universal strategies that can be used to serve any customers with barriers to employment, not just individuals with disabilities. (Authors)||||||Jun 18 2007 2:47PM|0|||The Office of Disability Employment Policy (ODEP); |U.S. Department of Labor the Office of Disability Employment Agency||2005|Washington, D.C.|48||0|NULL|NULL|http://www.dol.gov/odep/documents/3a71dce9_0f04_4e80_8533_aeda57aa48b0.pdf|||NULL|13
26392|School Nurses: It's Not Just Bandages Anymore!|School nurses operate increasingly complex clinics to track and administer care to their school's students. Fro students experiencing homelessness, school nurses can play a vital role in addressing their health needs and improving their opportunities to succeed in school. From routine administration of medications and care for bumps and strains, to the unexpected emergency, school nurses are often the only health care providers who see these children regularly. Students experiencing homelessness may be at risk for illness, lack immunizations records, and be long overdue for routine preventative physicals. As healthcare costs continue to rise, families are finding it more difficult to meet the health demands of their children. Thus the school nurse might be the students' only resource for assessment and referrals to medical care. Homelessness is a social dilemma that had academic repercussions. It can be caused by nay number of factors, but the following are most often cited: lack of affordable housing, domestic violence, and job loss. Increased costs of food and healthcare aggravate the precarious situations that some families experience. an economic downturn can make that situation worse. The most vulnerable families are those with a single income. It has estimated that 40 percent of those who are homeless are families with at least one child. In 2003 83 percent of cities reported an increase in requests for housing assistance by low-income families and individuals. (Author)||||||Jun 18 2007 3:12PM|0|NULL|NULL|Lilliston, Jennifer;|Project HOPE||2004|Williamsburg, VA|48||1|NULL|NULL|http://www.wm.edu/about/search/|||NULL|13
26394|Working with People with Mental Illness Involved in the Criminal Justice System: What Mental Health Service Providers Need to Know|Increasing numbers of people with mental illness are becoming involved with the criminal justice system, and unfortunately many providers are resistant to working with the justice system for many reasons, most relating to issues beyond their control. Serving this population is simply the right thing to do. It is also a surprise to many providers that they have been serving this population for quite some time. While the focus is in people referred from the criminal justice system, many people with criminal justice histories enter mental health service systems through typical referral channels such as crisis services, departments of social services, human service agencies, educational programs, families, and self-referrals. Those who are referred from the courts, probation departments, jails, and police are not necessarily dangerous or violent. In some cases, the criminal justice involvement many signal a more serious illness or greater urgency for comprehensive services. However, these individuals have similar needs to other individuals with mental illness or current case loads. Providing services to this population does not differ substantially from serving others and may prevent future arrest or incarceration. (Author)||||||Jun 18 2007 3:46PM|0|||Massaro, Jackie; |TAPA Center for Jail Diversion, National GAINS Center, Substance Abuse and Mental Health Services Administration (SAMHSA)||2004|Delmar, NY|48||1|NULL|NULL|http://gainscenter.samhsa.gov/pdfs/jail_diversion/Massaro.pdf|||NULL|14
26395|Overview of the Mental Health Service System for Criminal Justice Professionals|The criminal justice and mental health service systems appear to meet very different societal needs, yet they overlap in two significant ways. First, they both seeks to maintain the safety of the people in the community; second, both systems work with the same individual. This publication provides criminal justice professionals with basic information about the adult mental health service system, and its highlights some of the common challenges for the mental health and criminal justice systems in meeting the needs of adults with mental illnesses. It is intended as a reference for judges and other court personnel, attorneys, jail services, prison services, diversion programs, probation departments, parole services, alternative-to-incarceration programs, and law enforcement. The CMHS GAINES technical Assistance and Policy Analysis Center for Jail Diversion (TAPA) has made available a companion monograph for mental health service providers, Working with people with Mental Illness Involved with the Criminal Justice System: What Mental Health Service Providers Need to Know (Massaro 2004), which may be useful to providers that fill both criminal justice and mental health role. In addition the Bureau of Justice Assistance Mental Health Court Grant Program is schedule to release a brief entitled, Navigated the Mental Health Maze : A Guide for Court Practitioners, which provides more in-depth information about the treatment of mental illness (Osher & Levine 2005). (Author)||||||Jun 19 2007 9:32AM|0|||Massaro, Jackie; |CMHS GAINS TAPA Center for Jail Diversion||2005|Delmar, NY|48||1|NULL|NULL|http://www.schizophrenia.com/pdfs/criminaljustice.pdf|[email protected]|866-518-8272|NULL|13
26398|Identifying and Selecting Evidence-Based Interventions: Guidance Document for the Strategic Prvention Framework State Incentive Grant Program|The purpose of this guidance is to assist State and community planners in applying the Substance Abuse and Mental Health Services Administration's (SAMHSA's) Strategic Prevention Framework (SPF) to identify and select evidence-based interventions that address local needs and reduce substance abuse problems. (Authors)||||||Jun 19 2007 10:23AM|0|||Center for Substance Abuse Prevention; |Substance Abuse and Mental Health Services Association (SAMHSA)||2007|Rockville, MD|48||1|NULL|NULL|http://store.samhsa.gov/shin/content/SMA09-4205/SMA09-4205.pdf|||NULL|14
26399|Families Reap Substantial Benefits under the Community Partnership to End Homelessness Act of 2007|The Community Partnership to End Homelessness Act of 2007, S. 1518, introduced by Senator Jack Reed (D-RI), Sen Wayne Allen (R-CO) and 11 other original correspondents would substantially improve federal policy regarding homelessness Families with children are the group that would probably benefit the most from the changes that CPEHA makes in the current system. Homelessness families, when asked, are extremely clear about what they want and what would help them: they want help securing housing. This bill places the focus there, on housing and supportive services that are often needed to keep families stably housed. (Authors)||||||Jun 20 2007 10:28AM|0|NULL|NULL|NULL|National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://www.endhomelessness.org/content/article/detail/1657|||NULL|13
26401|HUD Appropriations Bill|On Tuesday, June 12, the Transportation-HUD Appropriations Subcommittee marked up its spending bill for Fiscal Year 2008. Although the bill has not been released publicly, preliminary reports indicate that McKinney Homeless Assistance Grants received an increase of $119 million over FY 2007 to $1.561 billion. Several other programs, including Section 8 tenant-based and project-based rental assistance, public housing operating fund and capital fund, HOPE VI, Community Development Block Grants, and Section 202 housing for the elderly also received increases. The Full Committee markup of the Transportation-HUD Appropriations bill was originally scheduled for Monday, June 18, but has been postponed. (Authors)||||||Jun 20 2007 10:46AM|0|NULL|NULL|NULL|Department of Veteran Affairs, Housing and Urban Development||2007|Washington, D.C.|48||0|NULL|NULL|http://appropriations.house.gov/pdf/FY07-302b.pdf|||NULL|14
26402|Senate 302(b) Allocations|The Committee on Appropriations submits the following report pursuant to section 302(b) of the Congressional budget Act of 1974, as amended, and section 7035 of Public Law 109-234. The Budget Act requires that as soon as practicable after a concurrent resolution on the budget is agreed to, the Committee of Appropriations shall submit to the Senate a report subdividing among its subcommittees the new budget authority and total outlays allocated to the Committee in the joint explanatory statement accompanying the conference reports on such resolution. Under the provison of section 301(a) of the Budget Act, the Congress shall complete action on a concurrent resolution on the budget no later than April 15th each year. In the absence of such congressional action, on June 15th 2006, the President approved the Emergency Supplemental Appropriations Act for Defense, the Global War on Terror, and Hurricane Recovery, 2006 (public law 109-234) Section 7035 of that act provides section 302(a)allocations to the Committee on Appropriations for fiscal year 2007. These allocations will remain until the adoption of Congress of a budget resolution. the appropriation is not without precedent. A similar procedure (S. Res. 308; 101st Congress)was agreed to in the senate on July 12th 1990, providing an allocation for fiscal year 1991. A similar resolution (S. Res. 209; 105th Congress) was agreed to in the Senate on April 2, 1998, providing an allocation for the Committee for fiscal year 1999. Again, in August 2004, the President approved the Department of Defense Appropriations Act, 2005 (Public Law 108-287). Section 14007 of that act set an allocation consistent with the conference report on S. Con. Res. 95, the budget resolution for fiscal year 2005. That conference report was never adopted by the Congress. (Authors)||||||Jun 20 2007 11:02AM|0||||Committee on Appropriations|49-010|2007|Washington, D.C.|48||0|NULL|NULL|http://www.gpo.gov/fdsys/pkg/CRPT-109srpt268/pdf/CRPT-109srpt268.pdf|||NULL|14
26404|Fact Checker: Youth Homelessness|Youth Homelessness is disturbingly common. Although the prevalence of youth homelessness is difficult to measure, researchers estimate that about 5-7.7 percent of youth experience homelessness each year. The same factors that contribute to adult homelessness, such as poverty, lack of affordable housing, low education levels unemployment, mental health and substance abuse, can lead to homelessness among youth. Beyond those factors, youth homelessness is largely a reflection of family breakdown. (NAEH)||||||Jun 20 2007 11:23AM|0||||National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://www.endhomelessness.org/library/entry/fact-sheet-youth-homelessness|||NULL|31
26405|Making the Child Welfare System Work for Older Youth|Few systems are as vital to a community as child welfare- a complex interface of programs to ensure vulnerable children's safety. The dynamic steps in protecting these children include support and preservation of families, investigation of abuse and neglect reports, the removal of children from their parents homes if necessary, and foster care and adoption. Our work focuses on: vulnerable families- we watched trends in the number of children in families facing such risks such as domestic violence and substance abuse. Adoption- we evaluated one of the largest media-base efforts to to recruit adoptive parents for children in foster care. Financing- we tracked annual child welfare spending trends for the past five years. Kinship care- we conducted the first nationally represented survey that profiled children in various types of kinship care arrangements. Youth aging out- we identified promising independent living programs for foster care youth for a random-assignment experiment. Screening and rapid response- we proved it is possible to measure the number of children maltreated allegations screened out by states prior to formal investigations. Marriage and Parenting- we shed light on the need for child welfare agencies to address adult relationships as part pf reuniting children with their families. (Authors)||||||Jun 20 2007 11:38AM|0||||Theb Urban Institute||2007|Washington, D.C.|48||0|NULL|NULL|http://www.urban.org/Pressroom/thursdayschild/june2007.cfm|||NULL|13
26406|Housing Development: Conference Track|Recommended workshops for conference participants who are developing or interested in developing affordable or permanent supportive housing. (Authors)||||||Jun 20 2007 11:42AM|0|NULL|NULL|NULL|National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://www.endhomelessness.org/content/article/detail/1655|||NULL|13
26407|Promising Strategies to End Family Homelessness|Family homelessness is more wide spread than you may think, but it is not an unsolvable problem. Across the country hundreds of communities are planning to end homelessness, and a handful of communities and local programs are making progress to end family homelessness. This paper highlights the strategies promising communities are using to accomplish the goal of ending family homelessness. (Authors)||||||Jun 20 2007 11:46AM|0|NULL|NULL|NULL|National Alliance to End Homelessness (NAEH)||2006|Washington, D.C.|48||0|NULL|NULL|http://www.endhomelessness.org/library/entry/promising-strategies-to-end...|||NULL|13
26408|Ending Family Homelessness: Conference Track|Recommended workshops for conference participants focused on ending family homelessness. The recommended workshops focus on the five strategies that promising communities have adopted to respond to familiy homelessness. The five strategies are highlighted in Promising Strategies to End Familiy Homelessness. The final workshop will focus on the policy shifts that are required to facilitate broader progress. (Author)||||||Jun 20 2007 11:51AM|0|NULL|NULL|NULL|National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://www.endhomelessness.org/content/article/detail/1654|||NULL|13
26409|Community Partnership to End Homelessness Act of 2007 Analysis|Senator Reed (D-RI), Senator Allard (R-CO), and 11 other Senators introduced the Community Partnership to End Homelessness Act of 2007 (S. 1518) on May 24. The bill would change federal funding of homeless assistance by making it more flexible, particularly in rural communities. It would also expand the amount of homelessness prevention and increase the emphasis on performance and accountability. The Act would support communities through the life cycle of implementing their ten year plans to end homelessness. • It would provide incentives to develop solutions that are research tested and cost effective and then phase them out as they are fully implemented. • It would address the needs of households who are doubled up or living in precarious housing situations by providing prevention and re-housing assistance to prevent them from ever becoming homeless. • As communities successfully reduce homelessness, the Act allows them to focus more of their resources on homelessness prevention. This document summarizes the significant features of the Act, describing how homeless assistance would differ from existing practice and how homeless people, providers, and communities would be affected. The summary is followed by a more detailed analysis of the bill’s features. (Authors)||||||Jun 21 2007 12:03PM|0||||National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://monarchhousing.org/wordpress/wp-content/uploads/2007/06/reedbills...|||NULL|13
26411|Fact Checker: Domestic Violence|Domestic violence is the immediate cause of homelessness for many women and children. In November 2006, over 22,000 victims of domestic violence—12,000 children and 10,000 adults—received housing services from 1,243 domestic violence service providers. Domestic violence victims are often isolated from support networks and financial resources by their abusers, meaning they may lack steady income, employment and credit histories, and landlord references. Safe and stable housing is the most immediate need for survivors of domestic violence to prevent them from staying with their abuser or sleeping on the streets. (National Alliance to End Homelessness)||||||Jun 21 2007 12:18PM|0||||National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://www.endhomelessness.org/content/article/detail/1647|||NULL|31
26412|A Doctor's Experience: Talking with Mrs. F.|"I concentrated on using the latest technology to make the correct diagnosis." But after working with people who are homeless, Bechara Choucair talks and listens "so I can understand what they want and need."||||||Jun 22 2007 4:18PM|0|NULL||Gillis, Laura;|||2007||48||0|NULL|NULL||[email protected]|617-467-6014|NULL|32
26413|Finding Her Voice|Laura Gillis caught up with Amy Grassette to talk about her experience of being homeless, the impact that had on her family, and how she managed to work through the adversity to stabilized her and her family's lives.||||||Jun 22 2007 5:15PM|0|||Gillis, Laura M.; |||NULL||48||0|NULL|NULL||||NULL|32
26414|The ABC's of Self Care|Caregivers of homeless individuals and families work tirelessly to ensure their clients’ needs are met. This can be both rewarding and draining. Tension often exists between feeling inspired by our work and feeling frustrated about the many things we cannot control. It is not unusual to feel stressed and weighed down by working with people experiencing homelessness.||||||Jun 22 2007 5:25PM|0|||Gillis, Laura; |||NULL||48||0|NULL|NULL||[email protected]|617-467-6014|NULL|32
26415|Understanding Bodily Responses to Trauma|This resource provides valuable information about the traumatic responses that individuals experience homelessness may exhibit.||||||Jun 22 2007 5:32PM|0|||Gillis, Laura; |SAMHSA||2009|Rockville, MD|48||0|NULL|NULL||[email protected]|617-467-6014|NULL|32
26417|Homeless Enumeration for the Washington Metropolitan Region|For the first time since 2004, the homeless population has declined in the District of Columbia. The homeless population in the District dropped from 6,157 in 2006 to 5,757 in 2007, a 6.5 percent decline. The number of unsheltered homeless people, those sleeping in places not intended for human habitation, declined by over 11 percent from the previous year. These decreases happened concurrently with an increase in the number of permanent supportive housing units in the region. Just over 35 percent of homeless people in DC were in families with children. That percent increased to over 60 percent in some of the surrounding regions. Overall, 25 percent of individuals and 43 percent of adults in families were homeless despite being employed at the time of the count. (National Alliance to End Homelessness)||||||Jun 29 2007 2:03PM|0|NULL|NULL|NULL|The Homeless Services Planning and Coordinating Committee||2007|Washington, D.C.|48||0|NULL|NULL|http://www.mwcog.org/uploads/pub-documents/z1hbWg20070613141807.pdf|||NULL|13
26418|McKinney Reauthorization Hearing|On June 21, the Senate Committee on Banking, Housing, and Urban Affairs held a hearing on S. 1518, the Community Partnership to End Homelessness Act (CPEHA), a bill to reauthorize the McKinney-Vento Homeless Assistance Act. CPEHA was introduced by Sen Jack Reed (D-RI) and Sen. Wayne Allard (R-CO) on May 24 and it currently has 16 cosponsors. On the first panel, the witnesses were Roy Bernardi, Deputy Secretary of HUD; Adrian Fenty, Mayor of Washington, DC; and Shirley Franklin, Mayor of Atlanta. All three spoke in favor of CPEHA. The two mayors, in particular, were adamant that CPEHA would greatly benefit their cities by granting more flexibility and adding efficiency to the application process. The second panel consisted of Lloyd Pendleton, Director of the Homeless Task Force at the State of Utah Division of Housing and Community Development; Carol Gundlach, Executive Director of the Alabama Coalition Against Domestic Violence; Moises Loza, Executive Director of the Housing Assistance Council; Linda Glassman, Board Secretary of the National AIDS Housing Coalition; and Nan Roman, President of the National Alliance to End Homelessness. Overall, panelists expressed strong support for CPEHA, focusing especially on the improvements that would result from the new prevention and rural homelessness titles. (National Alliance to End Homelessness)||||||Jun 29 2007 2:05PM|0|NULL|NULL|Roman, Nan;|National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://www.endhomelessness.org/library/entry/testimony-to-the-senate-com...|||NULL|13
26419|Labor-H Appropriations|Last week, the Senate Appropriations Committee marked up its Labor-HHS- Education spending bill for FY 2008. The bill included several increases for homelessness programs: Runaway and Homeless Youth Act (RHYA) programs received a $20 million increase to $123 million; Grants to Benefit Homeless Individuals (GBHI) was level funded at $44 million; Homeless Veterans Reintegration Program received a $1.8 million increase to $23.6 million; Health Care for the Homeless (HCH) received an increase of approximately $21.7 million to $194.5 million; Projects in Assistance for Transition from Homelessness (PATH) was level funded at $54 million; Community Services Block Grant (CSBG) was increased by $40 million; and Social Services Block Grant (SSBG) was level funded. (Authors)||||||Jun 29 2007 2:10PM|0|NULL|NULL|NULL|National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://www.appropriations.senate.gov/|||NULL|13
26420|Congress Hold Hearing on Youth Homlessness|On June 19th, Representative Jim McDermott sponsored a Ways and Means Subcommittee hearing on Disconnected and Disadvantaged Youth. At the hearing, the National Alliance to End Youth Homelessness, as a partner of the Re*Generation National Homeless Youth Task Force, petitioned for increased funding dedicated for serving and supporting homeless youth. Together with three-time Grammy-nominee Jewel, Deborah Shore and DeCario Whitfield from Sasha Bruce Youth Services, a D.C. youth homelessness service organization, testified before Congressional members to talk about their personal experiences and employment and educational services needed to support homeless youth. Additional testimony was given by Representatives John Yarmuth (D-KY) and Michele Bachmann (R-MN). The national homeless youth task force is also working to have November designated as National Homeless Youth Awareness Month (Authors)||||||Jun 29 2007 2:12PM|0|NULL|NULL|NULL|National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://www.endhomelessness.org/content/article/detail/1664|||NULL|13
26421|Gulf Coast Housing Bill Introduced in Senate|On June 20, Senators Chris Dodd (D-CT) and Mary Landrieu (D-LA) introduced S. 1668, a bill that would address the housing needs of the hurricane- damaged Gulf Coast. The House has already passed similar legislation (H.R. 1227). The Senate bill has been referred to the Committee on Banking, Housing, and Urban Affairs. (Authors)||||||Jun 29 2007 2:17PM|0|NULL|NULL|NULL|National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://www.govtrack.us/congress/bills/110/hr1227|||NULL|13
26422|Planning and Oversight: A Conference Track|As the movement builds to develop and implement plans to end homelessness, communities are learning from one another about the crucial elements for success. The Alliance has organized a planning and oversight workshop track at the Conference on Ending Homelessness to help share key learnings. State and local government officials, advocates, and people involved in the continuum of care or ten year planning process should attend these sessions where they will hear from their peers about developing a ten year plan, measuring performance, conducting point-in- time counts, oversight, assessment and targeting, helping shelters and transitional housing programs through transitions, and partnering with the private sector. This summary (link) describes these workshops and others recommended for conference participants interested in these topics. (National Alliance to End Homelessness)||||||Jun 29 2007 2:21PM|0||||National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://www.endhomelessness.org/content/article/detail/1662|||NULL|13
26423|The State of the Nation's Housing 2007|The length and depth of the current correction will depend on the course of employment growth and interest rates, as well as the speed with which builders pare down excess supply. But the longer term outlook for housing is more upbeat. Thanks in large part to recent immigrants and their native-born children, household growth between 2005 and 2015 should exceed the strong 12.6 million net increase in 1995–2005 by some 2.0 million. Together with the enormous increase in household wealth over the past 20 years, healthy income growth will help propel residential spending to new heights. But housing affordability remains a pervasive problem. In just one year, the number of households with housing cost burdens in excess of 30 percent of income climbed by 2.3 million, hitting a record 37.3 million in 2005. Making real headway against this disturbing trend requires an unlikely combination of structural and public policy shifts—that state and local governments ease development regulations that drive up production costs, the federal government adds meaningfully to already significant expenditures aimed at relieving heavy housing cost burdens, and economic growth dramatically lifts the real incomes and wealth of the bottom quarter of households. (Joint Center)||||||Jul 2 2007 3:40PM|0||||Joint Center for Housing Studies of Harvard University||2007|Cambridge, MA|48||1|NULL|NULL|http://jchs.harvard.edu/research/publications/state-nations-housing-2007||617-495-7908|NULL|13
26425|The Faces of BRC|Q&A With Andrew Apicella, Director of BRC Street Outreach||||||Jul 3 2007 11:33AM|0|NULL||NULL|Bowery Residents' Committee||2006|New York, NY|48||0|NULL|NULL|http://www.brc.org/pdf/outreach_qa.pdf|||bmh2b4g0.jpg|38
26428|Complex Trauma in Children and Adolescents|The term complex trauma describes the dual problem of children’s exposure to traumatic events and the impact of this exposure on immediate and long-term outcomes. Complex traumatic exposure refers to children’s experiences of multiple traumatic events that occur within the caregiving system – the social environment that is supposed to be the source of safety and stability in a child’s life. Typically, complex trauma exposure refers to the simultaneous or sequential occurrences of child maltreatment—including emotional abuse and neglect, sexual abuse, physical abuse, and witnessing domestic violence—that are chronic and begin in early childhood. Moreover, the initial traumatic experiences (e.g., parental neglect and emotional abuse) and the resulting emotional dysregulation, loss of a safe base, loss of direction, and inability to detect or respond to danger cues, often lead to subsequent trauma exposure (e.g., physical and sexual abuse, or community violence). (Authors)|NULL|35|Psychiatric Annals|390-398|NULL|Jul 3 2007 3:08PM|0|NULL|NULL|Cook, Alexandra;Spinazzola, Joseph;Ford, Julian;Lanktree, Cheryl;Blaustein, Margaret;Cloitre, Marylene;DeRosa, Ruth;Hubbard, Rebecca;Kagan, Richard;Liautaud, Joan;Mallah, Karen;Olafson, Erna;van der Kolk, Bessel;|NULL|NULL|2005|NULL|48|NULL|0|NULL|NULL|http://www.nctsnet.org/nctsn_assets/pdfs/edu_materials/ComplexTrauma_All...|[email protected]|NULL|NULL|6
26429|Attachment, Self-regulation and Competency|The Attachment, Self-Regulation and Competency (ARC) model provides a framework for understanding the individualized experiences and needs of children who have experienced complex trauma. The ARC model is a flexible intervention that assists clinicians in forming a therapeutic foundation for healing and transforming traumatic experiences. This article provides theoretical underpinnings and examples of intervention components for the three main areas covered by ARC. (Authors)|5|35|Psychiatric Annals|424-430|NULL|Jul 3 2007 3:11PM|0|NULL|NULL|Kinniburgh, K.;Blaustein, Margaret;Spinazzola, Joseph;van der Kolk, Bessel;|NULL|NULL|2005|NULL|48|NULL|0|NULL|NULL|NULL|NULL|NULL|NULL|6
26430|Trauma and Post-Traumatic Stress Among Homeless Men: A Review of Current Research|As the prevalence of homelessness among men increases, the impact of trauma and post-traumatic stress disorder in the lives of homeless men warrants attention. We will review research and clinical reports on the impact of traumatic event exposure, the antecedents and consequences of traumatic events, and homelessness among males in order to begin to develop scientific, public health, and social policy answers to several questions. The nascent clinical and scientific literature provides evidence of the need for prospective studies of the etiology, epidemiology, course, and prevention of post-traumatic stress disorder among males who are at risk for or in the early stages of homelessness. We attempt to summarize, categorize, and suggest important variables and causal relationships that can inform future research studies and interventions in order to contribute to the growth of this underdeveloped and important knowledge base. (Authors)|2|13|Journal of Aggression, Maltreatment & Trauma|1-22||Jul 3 2007 3:17PM|1|NULL||Kim, Mimi;Ford, Julian;|||2006||48||0|NULL|NULL|http://cat.inist.fr/?aModele=afficheN&cpsidt=18301165|[email protected]||NULL|6
26431|A Qualitative Study of Early Family Histories and Transitions of Homeless Youth|Using intensive qualitative interviews with 40 homeless youth, this study examined their early family histories for abuse, neglect, and other family problems and the number and types of transitions that youth experienced. Multiple forms of child maltreatment, family alcoholism, drug use, and criminal activity characterized early family histories of many youth. Leaving home because of either running away or being removed by child protective services often resulted in multiple transitions, which regularly included moving from foster care homes to a group home, back to their parents, and then again returning to the streets. Although having experienced family disorganization set youth on trajectories for early independence, there were many unique paths that youth traveled prior to ending up on the streets. (Author)|10|21|Journal of Interpersonal Violence|1385-1393|NULL|Jul 3 2007 3:21PM|1|NULL|NULL|Tyler, Kimberly;|NULL|NULL|2006|NULL|48|NULL|0|NULL|NULL|http://jiv.sagepub.com/content/21/10/1385.abstract|NULL|NULL|NULL|6
26432|House of Representatives Introduces Bill to Create a National Housing Trust Fund|On Thursday, June 28, House Financial Services Chairman Barney Frank (D-MA) and 16 bipartisan cosponsors introduced H.R. 2895, the National Affordable Housing Trust Fund Act of 2007. The bill would establish a national housing trust fund with the goal of constructing, rehabilitating, and preserving 1.5 million units of affordable housing over the next ten years. The bill prioritizes extremely low income people and people whose incomes qualify them for SSI benefits. Funding for the national housing trust fund would come from several sources, two of which have already been identified: funds from H.R. 1427, the bill to reform Government Sponsored Enterprises Fannie Mae and Freddie Mac (has been passed by the House), and funds from H.R. 1852, which would modernize the Federal Housing Administration (has been passed by the House Financial Services Committee). At a press conference to introduce the bill, Representatives Frank, Waters (D-CA),Ramstad (R-MN), and Shays (R-CT), were joined by several supporting organizations. Alliance President Nan Roman said, "The National Housing Trust Fund is a giant step in the right direction, as it attacks the root cause of homelessness-a lack of affordable housing. This landmark bill will meet the housing needs of thousands of America's lowest income families." (National Alliance to End Homelessness)||||||Jul 5 2007 11:24AM|0||||National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://monarchhousing.org/2007/07/03/house-of-representatives-introduces...|[email protected]|202-942-8248|NULL|13
26433|Bill Introduced to Reform HUD Section 202 Program|Last week, Representative Tim Mahoney (D-FL) introduced H.R. 2930, a bill to reform HUD's Section 202 Supportive Housing for the Elderly. The legislation would make changes to Section 202's assisted living conversion program, would modify the process for refinancing Section 202 properties, and would make several construction reforms to the program. The bill has been sent to the House Committee on Financial Services. Congress in Recess Both the House and the Senate are in recess this week for the Fourth of July holiday. The House will reconvene on July 9 and the Senate on July 10. (Author)||||||Jul 5 2007 11:27AM|0|NULL|NULL|NULL|National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://www.mahoney.house.gov/images/stories/documents/mahoney_bill.pdf|||NULL|13
26434|Community Snapshot: Portland, Oregon|The Alliance has released Community Snapshot: Portland, Oregon. The community snapshot series highlights strategies, programs, and innovations in communities that have succeeded in decreasing homelessness. In Portland, through the implementation of programs that focus on discharge planning, outreach, prevention, and permanent housing, homelessness decreased by 13 percent from 5,103 in 2005 to 4,456 in 2007. (Authors)||||||Jul 5 2007 11:29AM|0|NULL|NULL|NULL|National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://www.endhomelessness.org/content/general/detail/1665|||NULL|13
26435|Joe Breiteneicher: 1945-2007|The Alliance notes with sadness the death of Joe Breiteneicher, President and CEO of The Philanthropic Initiative (TPI). Mr. Breiteneicher joined TPI in 1990 as senior consultant to organized Philanthropy and became President and CEO in 2001. He helped create several initiatives, including New Ventures in Philanthropy, a collaboration to stimulate local giving in communities; International Network on Strategic Philanthropy, a forum on the role of philanthropy; and The Mellville Charitable Trust, a family foundation devoted to ending homelessness. Mr. Breiteneicher said the Melville Charitable Trust had accomplished an understanding of homelessness that was beyond anyone's efforts before, but that they also understood the foundation for real social change: 'We've learned a lot. Now build the damn units' (Authors)||||||Jul 5 2007 11:31AM|0|NULL|NULL|NULL|National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://www.tpi.org/|||NULL|13
26436|Evaluating the Cost of Homelessness|On Thursday, July 12 at 3 pm ET, the Alliance will host "Evaluating the Cost of Homelessness," an installment of the Leadership to End Homelessness Audio Conference Series. Cost analysis is a powerful tool for program administrators who make decisions on how to allocate scarce funding for housing and services and for advocates who are seeking to demonstrate a case for ending homelessness. Our special guest moderator will be Brooke Spellman of Abt Associatess. She will be joined by Evan J. Scully of Homeward. The Leadership to End Homelessness Audio Conference Series is a monthly series of national conference calls focusing on the leading strategies that states, local jurisdictions and nonprofit organizations have employed to end homelessness. The series is presented by the Council of State Community Development Agencies, the National Alliance to End Homelessness, the National Council of State Housing Agencies, the National League of Cities and the U.S. Conference of Mayors. The series is supported by the Sara Lee Foundation. (Authors)||||||Jul 5 2007 11:34AM|0||||National Alliance to End Homelessness (NAEH)||2007|Washington, D.C.|48||0|NULL|NULL|http://monarchhousing.org/2007/07/03/evaluating-the-cost-of-homelessness/|||NULL|25
26437|From Relief to Recovery: Peer Support by Consumers Relieves the Traumas of Disasters and Recovery from Mental Illness|This paper is about the love and solidarity, which grow from the suffering that people with mental illness understand first hand. We, who have been through the traumas of the disasters of our lives, immediately understand and feel impelled to respond to the victims of shared disasters. At times of disaster, peer support has served as a vital complement to professional services. Following the bombing of the Murrah Building in Oklahoma City and the destruction of the twin towers in New York City on 9/11, mental health consumers provided valuable peer support services to traumatized individuals. Much like in New York, peers are also being mobilized to assist in relief efforts in Louisiana following hurricanes Katrina and Rita. This paper describes how the peer-based, recovery approach to assisting those with mental illness following disaster is consistent with crisis counseling following disasters. This means that peer support not only provides relief from trauma, but in so doing assists in peoples’ recovery from mental illness. Mental health consumers’ experiences with recovery from a variety of trauma have equipped us well to assisting people at times of disaster. Indeed, the shift in role from passive victim of a disaster to active agent providing assistance plays a valuable role in relief from trauma, as well as recovery from mental illness. The state of Louisiana following Hurricanes Katrina and Rita serves as a case example of the challenges and advantages of providing peer support services. From the Louisiana experience and others discussed in this paper, it is clearly important to prepare for disasters proactively by developing a network of peer supporters across each state. (Authors)||||||Jul 6 2007 11:21AM|0|||Fisher, Daniel; Rote, Kay; Miller, LaVerne; Romprey, David; Filson, Beth; |National GAINS Center||2006|Bethesda, MD|48||1|NULL|NULL|http://www.witnessjustice.org/violence/docs/fromrelieftoecovery_peersupp...|[email protected]||NULL|13
26438|Criminal Justice Systems Issues and Response in Times of Disaster|As the world watched, Hurricane Katrina came ashore leaving in its wake what President Bush has called “the worst natural disaster in the history of our country.” As people around the world witnessed the devastation of Hurricane Katrina and then Hurricane Rita unfold, local, state and federal governments, alongside national disaster response organizations, began to realize that this disaster would overwhelm resources like never before. Countless stories of devastation and of heroism were told. Through it all, the discovery that although there has been tremendous progress over the years in the development of disaster response plans and protocols, every disaster brings with it new challenges, prompting review and revision of these plans. One area in disaster response plans that is critical to the survival of those impacted is the behavioral health component. As the role of behavioral health systems in disasters continues to evolve, one of the many vulnerable populations to be examined are those individuals who were in the criminal justice system prior to the disaster, as well as those who enter the system post-disaster, particularly those with previous mental health, substance abuse and/or trauma histories. (Author)||||||Jul 6 2007 11:24AM|0|||McCown, Angela; |National GAINS Center||2006|Bethesda, MD|48||0|NULL|NULL|http://gainscenter.samhsa.gov/atc/text/papers/criminal_justice_paper.htm|||NULL|13
26440|Trauma and Retraumatization|The trauma that is the focus of the “After the Crisis: Healing from Trauma after Disasters” initiative is not the trauma of emergency medicine – traumatic bodily injury, whether from accidents, beatings, or disasters – although it certainly intersects with such injury. A distinction is often made between a traumatic event and “psychological trauma” (e.g., Herman, 1992b), the impact on the individual of experiencing a traumatic event. Frequently, the word ‘trauma’ is used as a short-hand for both. Attention is paid in the literature to distinguishing between traumatic life events and stressful life events, with the line often drawn, in keeping with the Diagnostic and Statistical Manual of Mental Disorders (DSM), between those events that involve “threat of death or serious injury” and, according to the current edition of the DSM (DSM-IV-TR [Text Revision]) (American Psychiatric Association [APA], 2000), also an “emotional response of fear, helplessness, or horror at the time of the precipitating event” and other “painful and stressful events that constitute the normal vicissitudes of life, such as divorce, loss, serious illness, and financial misfortune” (McHugo et al., 2005a, p. 114-115). Today’s world is replete with examples of extreme life events, including war, ethnic cleansing, genocide, terrorist attacks, as well as tsunami, earthquakes, floods, tornadoes, and hurricanes – so-called “natural disasters” whose impact is frequently shaped by past and present human actions and inactions. (Authors)||||||Jul 6 2007 11:29AM|0|NULL|NULL|Kammerer, Nina;Mazelis, Ruta;|National GAINS Center||2006|Bethesda, MD|48||0|NULL|NULL||||NULL|13
26442|Victims of Violence in Times of Disaster or Emergency|When the dust settles from an earthquake or the waters recede following a flood, communities pull together to rebuild and heal. The survivors must cope not just with the trauma of the disaster itself, but also with the ongoing upheaval in their lives. Understandably, they are concerned about what the future holds. The stress and trauma that survivors experience are played out in a number of ways (e.g., alcohol and substance use, sleep disturbance, aggression and short-temperedness, domestic violence), and post-traumatic stress disorder and depression make it difficult to feel hopeful amidst the destruction. Hurricane Katrina reminds us that, despite the lessons learned from tragic events like the terrorist attack on September 11, 2001, Hurricane Hugo in 1989, and the Mount St. Helen’s volcanic eruption of 1980, much progress remains to be made in applying those lessons to foster change and implement more responsive practices. (Authors)||||||Jul 6 2007 11:32AM|0|||West, Helga; |National GAINS Center||2006|Bethesda, MD|48||0|NULL|NULL|http://www.vawnet.org/summary.php?doc_id=2520&find_type=web_sum_GC|||NULL|13
26444|Comprehensive Housing Marketing Analysis|HUD's Economic and Market Analysis Division prepares Comprehensive Housing Market Analysis that assist and guide HUD in its operations. The factual information, findings, and conclusions contained in the reports could also be useful to builders, mortgagees, and others concerned with local housing conditions and trends. For each analysis, HUD economists develop a factual framework based on information available, as of a particular date, from both local and national sources. Each analysis takes into consideration changes in the economic, demographic, and housing inventory characteristics of a specific housing market area during three periods: from 1990 to 2000, from 2000 to the as-of date of the analysis, and from the as-of date to a forecast date. The reports present counts and estimates of employment, population, households, and housing inventory. Click here for additional data pertaining to the housing market for the following Comprehensive Housing Market Analyses. (Authors) This website hosts reports dating back to 2002||||||Jul 10 2007 1:51PM|0|NULL|NULL|NULL|HUD User||2007|Washington, D.C.|48||0|NULL|NULL|http://www.huduser.org/portal/publications/econdev/mkt_analysis.html|||NULL|13
26448|Homeless People's Perception of Welcomeness and Unwelcomeness in Healthcare Encounters|Background: Homeless people face many barriers to obtaining health care, and their attitudes toward seeking health care services may be shaped in part by previous encounters with health care providers. Objective: To examine how homeless persons experienced “welcomeness” and “unwelcomeness” in past encounters with health care providers and to characterize their perceptions of these interactions. Design: Qualitative content analysis of 17 in-depth interviews. Participants: Seventeen homeless men and women, aged 29–62 years, residing at 5 shelters in Toronto, Canada. Approach: Interpretive content analysis was performed using iterative stages of inductive coding. Interview transcripts were analyzed using Buber’s philosophical conceptualization of ways of relating as “I–It” (the way persons relate to objects) and “I–You” (the way persons relate to dynamic beings). Results: Most participants perceived their experiences of unwelcomeness as acts of discrimination. Homelessness and low social class were most commonly cited as the perceived basis for discriminatory treatment. Many participants reported intense emotional responses to unwelcoming experiences, which negatively influenced their desire to seek health care in the future. Participants’ descriptions of unwelcoming health care encounters were consistent with “I–It” ways of relating in that they felt dehumanized, not listened to, or disempowered. Welcoming experiences were consistent with “I–You” ways of relating, in that patients felt valued as a person, truly listened to, or empowered. Conclusions: Homeless people’s perceptions of welcomeness and unwelcomeness are an important aspect of their encounters with health care providers. Buber’s “I–It” and “I–You” concepts are potentially useful aids to health care providers who wish to understand how welcoming and unwelcoming interactions are fostered. (Authors)|7|22|Journal of General Internal Medicine|1011-1017|NULL|Jul 11 2007 11:02AM|1|NULL|NULL|Wen, Chuck;Hudak, Pamela;Hwang, Stephen;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://link.springer.com/article/10.1007/s11606-007-0183-7|[email protected]|NULL|NULL|6
26449|Perspectives of Homeless People on Their Health and Health Needs Priorities|Aim: This paper is a report of a study of the perspectives of homeless individuals on their health and healthcare needs. Background: Many studies show the high incidence and severity of diseases, physical and mental, amongst the homeless populations. However, the views of homeless people themselves are usually omitted. In order to provide appropriate care, healthcare professionals need to be aware of these perspectives. Method: A descriptive, exploratory design, using semi-structured interviews and observational field notes, was chosen for this qualitative study. A convenience sample of 24 participants experiencing homelessness was recruited in one Canadian city in 2005. Findings: Participants described their health and healthcare needs in a holistic sense. They reported concerns about physical illnesses, mental health, addictions and stress. Shelter life promoted spread of diseases and lacked privacy. Violence was rampant in shelters and on the streets, leading to constant fear. There was emotional distress over social exclusion and depersonalization. Participants wanted to work and to be housed, yet felt trapped in a dehumanizing system. Conclusion: The recommendations are (a) elimination or mitigation of most health problems of the homeless through safe, affordable housing; (b) reintegration into the community through job counseling, treatment of addictions and employment. Negative societal attitudes towards these clients need to change. Healthcare professionals, particularly community nurses, have opportunities to collaborate respectfully with these clients and work for changes in public policies, such as national housing and addiction treatment policies, and for streamlined, humanized services to smooth the processes of social reintegration. (Author)|3|58|Journal of Advanced Nursing|273-281|NULL|Jul 11 2007 11:11AM|1|NULL|NULL|Daiski, Isolde;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://www.ingentaconnect.com/content/bsc/jan/2007/00000058/00000003/art...|NULL|NULL|NULL|6
26450|Mothers Experiencing Homelessness: Mental Health, Support and Social Care Needs|Little is known about the experiences of mothers who become homeless. The numbers of women with children in this situation are growing, most becoming homeless following domestic or neighbour abuse, or the breakdown of family relationships. This qualitative study aimed to describe mothers’ experiences of homelessness in relation to their mental health, support and social care needs. Twenty-eight homeless women with dependent children residing in hostels were interviewed. The experience of homelessness was stressful, but viewed as a respite for many of the participants because they had experienced violence and harassment prior to their stay in the hostels. Many described poor mental health, which they related to the conditions in hostels and traumas that they had experienced before becoming homeless. Their experiences and perceptions of the services available were mixed. Some valued the support offered by staff and other residents, but the majority felt that there was a lack of resources to address their needs. Many women had difficulty coping with homelessness, and several said that support from other homeless women was an important source of help. Services need to work together to meet the multiple health, social, psychological and housing needs of these women. (Authors)|3|15|Health and Social Care in the Community|246-253|NULL|Jul 11 2007 11:17AM|1|NULL|NULL|Tischler, Victoria;Rademeyer, Alison;Vostanis, Panos;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://onlinelibrary.wiley.com/|[email protected]|NULL|NULL|6
26451|Homeless Mothers: Is There a Relationship Between Coping Strategies, Mental Health and Goal Achievement?|This study examined the relationship between coping, mental health and goal achievement among homeless mothers. Seventy-two women took part and 44 were re-interviewed 4 months later. The Family Crisis Oriented Personal Evaluation Scales (F-COPES) were used to identify their coping strategies at the time of homelessness; the General Health Questionnaire (GHQ) measured mental health problems; and a semi-structured questionnaire identified their goals. Outcome measures at follow-up were goal achievement and mental health. A variety of coping strategies were used, with some differences ascertained according to reason for homelessness and age of respondent. Lower use of problem-focussed coping was associated with poorer mental health at the time of homelessness. Mental health problems improved over time, but levels of psychopathology remained high at follow-up. Most women had achieved their primary goal of resettlement, and this was associated with use of problem-focussed coping. Lower use of problem-focussed coping, in particular, acquiring social support, was associated with continuation of mental health problems at follow-up, however the greatest predictor of mental health at follow-up was mental health status whilst homeless. Despite exposure to major stressors and poor mental health, mothers experiencing homelessness can maintain their ability to cope effectively, in order to achieve their goals. (Authors)|2|17|Journal of Community and Applied Social Psychology|85-102|NULL|Jul 11 2007 11:21AM|1|NULL|NULL|Tischler, Victoria;Vostanis, Panos;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|NULL|NULL|NULL|NULL|6
26452|Strengths-Based Case Managements: Implementations With High-Risk Youth|Few effective methods of intervention exist for youth at risk for negative life outcomes. One method used successfully with both adults with chronic mental illness and adults with substance abuse problems is strengths-based case management (SBCM). Based on the principles of strengths theory, SBCM aims to assist individuals in identifying and achieving personal goals, with an emphasis on the case manager–client relationship and client self-determination. In the current study, the authors report findings from a feasibility study that implemented SBCM with adolescent runaways. Challenges to implementation, such as financial status, the role of families, abuse and neglect, developmental issues, education, peer relationships, and transportation, are examined. The current findings suggest that it is feasible to successfully implement SBCM with adolescents, but the challenges to application are different with this group compared with adults, given the developmental differences between adolescents and adults. (Authors)|1|88|Families in Society|86-94|NULL|Jul 11 2007 11:30AM|1|NULL|NULL|Arnold, Elizabeth;Walsh, Adam;Oldham, Michael;Rapp, Charles;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|NULL|NULL|NULL|NULL|6
26454|Treatment Outcome For Street-Living, Homeless Youth|Comprehensive intervention for homeless, street living youth that addresses substance use, social stability, physical and mental health issues has received very little attention. In this study, street living youth aged 14–22 were recruited from a drop-in center and randomly assigned to the Community Reinforcement Approach (CRA) or treatment as usual (TAU) through a drop-in center. Findings showed that youth assigned to CRA, compared to TAU, reported significantly reduced substance use (37% vs. 17% reduction), depression (40% vs. 23%) and increased social stability (58% vs. 13%). Youth in both conditions improved in many other behavioral domains including substance use, internalizing and externalizing problems, and emotion and task oriented coping. This study indicates that homeless youth can be engaged into treatment and respond favorably to intervention efforts. However, more treatment development research is needed to address the barriers associated with serving these youth. (Authors)|6|32|Addictive Behaviors|1237-1251||Jul 11 2007 11:38AM|1|||Slesnick, Natasha; Prestopnick, Jillian; Meyers, Robert; Glassman, Michael; |||2007||48||0|NULL|NULL|http://www.ncbi.nlm.nih.gov/pubmed/16989957||614-247-8469|NULL|6
26455|Newly Homeless Youth Typically Return Home|Newly homeless adolescents from Melbourne, Australia (n = 165) and Los Angeles, United States (n = 261) were surveyed and followed for 2 years. Most newly homeless adolescents returned home (70% U.S., 47% Australia) for significant amounts of time (39% U.S., 17% Australia more than 12 months) within 2 years of becoming homeless. (Authors)|6|40|Journal of Adolescent Health|574-576|NULL|Jul 11 2007 11:46AM|1|NULL|NULL|Milburn, Norweeta;Rosenthal, Doreen;Rotheram-Borus, Mary;Mallett, Shelley;Batterham, Philip;Rice, Eric;Soloria, Rosa;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://jahonline.org/webfiles/html/nocookies.html|NULL|NULL|NULL|6
26456|Screening for Chlamydia Trachomatis: Barriers for Homeless Young People|Objective: The study explored homeless young people's knowledge and attitudes of Chlamydia trachomatis (Chlamydia) and its screening. Design: Semi-structured interviews using focus groups. Setting: An inner city clinic for homeless young people. Subjects: Homeless young people aged 16-26 years. Outcomes: Perceptions of Chlamydia and its screening. Results: 19 males and 6 females aged 16 - 26 years participated. Content analysis confirmed a lack of knowledge, prior education and misinformation about Chlamydia and barriers to being screened. Ideas for informing young people about Chlamydia included advertising on billboards, in free newspapers, and improved school sex education programs. Conclusions: Homeless young people have poor knowledge of Chlamydia and its screening and barriers to the screening process. Culturally-specific education and health promotion programs and services are needed. (Authors)|3|24|The Australian Journal of Advanced Nursing|8-13||Jul 11 2007 11:58AM|1|||Henning, Dorothy; Ryan, Alice; Sanci, Lena; Dunning, Trisha; |||2007||48||0|NULL|NULL|http://www.ncbi.nlm.nih.gov/pubmed/17518159|||NULL|6
26457|Youth Leaving Care: How Do They Fare?|The purpose of this paper is to provide a brief overview of research/studies examining outcomes for youth who “age out” of the child welfare system. This is not an in-depth review; rather, it is a scan based primarily on information found on the Internet (generally post-1995) and recently published child welfare journals. Nonetheless, the findings presented show a consistently disturbing pattern of poor outcomes for youth leaving care. The paper concludes with a series of short- and long-term recommendations for governments’ consideration which could help improve outcomes of youths as they transition from care to adulthood. (Author)||113|New Direction for Youth Development|15-31||Jul 11 2007 12:23PM|0|||Tweddle, Anne; |||2005||48||0|NULL|NULL|http://www.ncbi.nlm.nih.gov/pubmed/17523520|||NULL|6
26458|Implementing A Social Enterprise Intervention With Homeless Street-Living Youths in Los Angeles|Homeless, street-dwelling youths are an at-risk population who often use survival behaviors to meet their basic needs. The traditional outreach approach brings services into the streets, yet does not adequately replace the youths' high-risk behaviors. Similarly, job training programs often fail to address the mental health issues that constitute barriers to their productive employment. Drawing on social development principles, the Social Enterprise Intervention (SEI) model is proposed as an alternative approach. The SEI seeks the tripartite effect of employment, service-related, and mental health outcomes for street youths. This article compares existing intervention models and suggests that through the SEI, homeless youths can acquire vocational and business skills, clinical mentorship, and linkages to services that otherwise would not be available to them, given their street-dwelling status. (Author)|2|52|Social Work|103-112||Jul 11 2007 12:31PM|1|||Ferguson, Kristin; |||2007||48||0|NULL|NULL|http://www.ncbi.nlm.nih.gov/pubmed/17580772|||NULL|6
26459|Youth Homelessness and Social Stigma|Building upon previous exploratory qualitative research (Kidd SA (2003) Child Adol Social Work J 20(4):235-261), this paper examines the mental health implications of social stigma as it is experienced by homeless youth. Surveys conducted with 208 youths on the streets and in agencies in New York City and Toronto revealed significant associations between perceived stigma due to homeless status and sexual orientation, pan handling and sex trade involvement, and amount of time homeless. Higher perceived stigma was also related to low self esteem, loneliness, feeling trapped, and suicidal ideation, with guilt/self-blame due to homeless status having the strongest impact on mental health variables (author)|6|36|Journal of Youth and Adolescence|291-299||Jul 11 2007 12:34PM|1|||Kidd, Sean; |||2007||48||0|NULL|NULL|http://link.springer.com/article/10.1007/s10964-006-9100-3|[email protected]||NULL|6
26461|Housing First for Long-Term Shelter Dwellers with Psychiatric Disabilites in a Suburban County: A Four-Year Study of Housing Access and Retention|Housing First is an effective intervention that ends and prevents homelessness for individuals with severe mental illness and co-occurring addictions. By providing permanent, independent housing without prerequisites for sobriety and treatment, and by offering support services through consumer-driven Assertive Community Treatment teams, Housing First removes some of the major obstacles to obtaining and maintaining housing for consumers who are chronically homeless. In this study, consumers diagnosed with severe mental illness and who had the longest histories of shelter use in a suburban county were randomly assigned to either one of two Housing First programs or to a treatment-as-usual control group. Participants assigned to Housing First were placed in permanent housing at higher rates than the treatment-as-usual group and, over the course of four years, the majority of consumers placed by both Housing First agencies were able to maintain permanent, independent housing. Results also highlight that providers new to Housing First must be aware of ways in which their practices may deviate from the essential features of Housing First, particularly with respect to enrolling eligible consumers on a first-come, first-served basis and separating clinical issues from tenant or housing responsibilities. Finally, other aspects of successfully implementing a Housing First program are discussed. (Authors)|NULL|28|Journal of Primary Prevention|265–279|NULL|Jul 11 2007 12:57PM|0|NULL|NULL|Stefancic, Ana;Tsemberis, Sam;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://link.springer.com/article/10.1007/s10935-007-0093-9|[email protected]|NULL|NULL|6
26462|Unstable Housing as a Factor for Increased Injection Risk Behavior at Us Syringe Exchanged Programs|Objective To assess variation in injection risk behavior among unstably housed/homeless injecting drug users (IDUs) across programs in a national sample of US syringe exchange programs. Methods About 23 syringe exchange programs were selected through stratified random sampling of moderate to very large US syringe exchange programs operating in 2001–2005. Subjects at each program were randomly sampled. Risk behavior interviews were collected using audio-computer assisted self-interviewing (A-CASI). “Unstable housing/homelessness” was operationally defined as having lived “on the street or in a shanty” or “living in a shelter or single room occupancy hotel (SRO)” at any time in the 6 months prior to the interview. “Receptive sharing” was operationally defined as having injected with a needle or syringe that “had been used by someone else” in the 30 days prior to the interview. Six very large and nine moderate-to-large programs had at least 50 subjects who reported unstable housing, and these 15 programs were used in the analyses. Results There was considerable variation among the 15 programs in the percentages of unstably housed participants (range from 35 to 74%, P < 0.0001), and in the percentages of unstably housed participants who reported receptive sharing (range from 8 to 52%, P < 0.0001). At each of the 15 programs, unstably housed exchange participants were approximately twice as likely to report receptive sharing than were stably housed participants. The weighted mean odds ratio was 2.02, 95% confidence interval, 1.68–2.41 (random effects model) and there was no statistically significant variation in these odds ratios. Across the 15 programs, receptive sharing among unstably housed participants was highly correlated with receptive sharing among stably housed participants (r = 0.95, P < 0.001, 90% of variance among unstably housed “explained” by variance among stably housed). Conclusions The programs clearly differ in the extent to which they are attracting unstably housed IDUs as participants. The consistency of more frequent injection risk behavior among unstably housed exchange participants and the lack of significant variation in the odds ratios for increased injection risk suggests that none of the programs were “better” or “worse” at reducing injection risk behavior among unstably housed participants. Reduction in injecting risk behavior among syringe exchange participants may require greater efforts to provide stable housing or the development of dramatically new interventions to reduce injecting risk behavior among IDUs with persistent unstable housing. (Authors)|April|NULL|AIDS and Behavior|NULL|NULL|Jul 11 2007 2:13PM|1|NULL|NULL|Des Jarlais, Don;Braine, Naomi;Friedmann, Patricia;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://link.springer.com/article/10.1007/s10461-007-9227-6|[email protected]|NULL|NULL|6
26463|Prospective Comparison of Methicillin-susceptible and Methicillin-Resistant Community-Associated Staphylococcus Aureus Infections in Hospitilized Patients|Background: We sought to determine the proportion of community-associated Staphylococcus aureus infections due to methicillin-resistant S. aureus (CA-MRSA)at a large county hospital. In addition, we sought to identify the demographic and clinical risk factors associated with CA-MRSA infection. Methods: Patients were prospectively enrolled if they were admitted to Parkland Hospital and had a positive culture for S. aureus isolated within 72 h of admission. The patients were interviewed using a standardized data questionnaire. Data collected included patient demographics, clinical history, as well as health care and non-health care associated MRSA risk factors. Bacterial susceptibilities were verified through review of microbiology laboratory and pharmacy records. Isolates were tested for Panton–Valentine leukocidin (PVL) gene, SCCmec type, and for inducible clindamycin resistance. Results: One hundred and ninety-eight patients were interviewed prospectively, of which eight had colonization without active infection. One hundred and nineteen patients were infected with MRSA and 71 patients were infected with methicillin-susceptible S. aureus (MSSA). Patients with MRSA were more likely to be African-American and unemployed. Patients with MRSA most commonly presented with a skin or soft tissue infection (SSTI): 69% versus 45%, p = 0.0012, while patients with MSSA were more likely to have infection of the respiratory tract: 11% versus 3%, p = 0.02. Patients with MRSA were more likely to have used antibiotics in the past six months, been homeless, have a history of incarceration, have abused alcohol and have a history of infection with MRSA. In multivariate analysis, African-American race, antibiotics in the past six months, and a history of being homeless were associated with MRSA infection. Only 11 of 119 (9%) MRSA patients did not have at least one of these risk factors. PVL gene was present in 72 of 74 (97%) MRSA isolates and SCCmec type IV was present in 63 of 75 (84%) MRSA isolates. Conclusions: The majority of patients hospitalized with community-associated S. aureus infections were due to MRSA, most of which involved an SSTI. African-American race, recent antibiotics and past homeless status predicted infection with MRSA; however, no clinical profile could reliably exclude MRSA. Clinicians should be aware of the increasing prevalence of CA-MRSA. (Authors)|4|54|Journal of Infection|427-434|NULL|Jul 11 2007 2:23PM|1|NULL|NULL|Skiest, Daniel;Brown, Katia;Cooper, Travis;Hoffman-Roberts, Holly;Mussa, Huda;Elliott, Alan;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://www.sciencedirect.com/science/article/pii/S0163445306002945|NULL|413-794-9966|NULL|6
26464|Differences in Clinical and Molecular Chracteristics of Skin and Soft Tissue Methicillin-Resistant Staphyloccccus Aureus Isolates Between Two Hospitals in Northern California|Community-onset methicillin-resistant Staphylococcus aureus (CO-MRSA) skin and soft tissue infections (SSTI) are associated with SCCmec IV and Panton-Valentine leukocidin (PVL) genes. CO-MRSA epidemiologic studies suggest that genotypic variation exists within one geographic region. We compared MRSA genotypes and demographic and clinical characteristics of patients with CO-MRSA SSTI between two regional medical centers. We also examined factors associated with SCCmec IV and PVL carriage. A total of 279 MRSA SSTI isolates from 2000 to 2002 at San Francisco General Hospital (SFGH) and Stanford University Hospital (SUH) were genotyped by pulsed-field gel electrophoresis and PCR for SCCmec and PVL genes. Medical records were reviewed for clinical characteristics. Ninety-three percent and 69% of MRSA SSTI were caused by CO-MRSA at SFGH and SUH, respectively. Patients with CO-MRSA SSTI at SFGH were more likely to be nonwhite, younger, homeless, and have no previous exposure to health care (P < 0.01). SFGH CO-MRSA strains were more likely to carry SCCmec type IV and PVL genes (90% and 55%, respectively) than SUH strains (29% and 16%, respectively). In multivariate analyses, nonwhite ethnicity was associated with both SCCmec type IV and PVL carriage (odds ratio [OR] of 2.65 and 95% confidence interval [CI] of 1.19 to 5.95 and OR of 1.94 and 95% CI of 1.03 to 3.65, respectively). ST8:USA300:IV became the dominant clone at SFGH, but not at SUH, by 2002. Despite geographic proximity, CO-MRSA SSTI exhibited differing SCCmec types, PVL carriage, and clonal dynamics. CO-MRSA SSTI at SUH were more likely to represent feral isolates of nosocomial origin. Clinicians should assess for nosocomial and community risk factors, realizing that different populations with CO-MRSA SSTI may require separate antimicrobial strategies. (Authors)|6|45|Journal of Clinical Microbiology|1798-1803|NULL|Jul 11 2007 2:31PM|1|NULL|NULL|Bhattacharya, Debika;Carleton, Heather;Tsai, Chiaojung;Baron, Ellen;Perdreau-Remington, Françoise;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://jcm.asm.org/content/45/6/1798.abstract?maxtoshow=&HITS=10&hits=10...|[email protected]|415-206-5438|NULL|6
26465|Education in a Homeless Shelter to Improve the Nutrition of Young Children|This resource provides information about a study conducted to determine the best way to educate homeless mothers and cafeteria workers about maintaining the nutrition of homeless children.|3|24|Public Health Nursing|249-255||Jul 11 2007 2:38PM|1|||Yousey, Yvonne; Leake, Jacquelyn; Wdowik, Melissa; Janken, Janice; |||2007||48||0|NULL|NULL|http://onlinelibrary.wiley.com/doi/10.1111/j.1525-1446.2007.00631.x/abst...|[email protected]||NULL|6
26466|High Prevalence of Overweight and Obesity in Homeless Baltimore Children and their Caregivers: a Pilot Study|CONTEXT: In the past, nutritional deficiencies were common among homeless families. Because obesity is currently a major public health issue in the United States, it is possible that obesity has supplanted nutritional deficiencies as the &quot;new malnutrition&quot; of the homeless.|1|79|Medscape General Medicine|48||Jul 11 2007 2:44PM|0|||Schwarz, Kathleen; Garrett, Beth; Hampsey, Jenifer; Thompson, Douglas; |||2007||48||0|NULL|NULL|http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1925022/|||NULL|6
26467|Psychiatric and Pyschosocial Correlates of Sexual Risk Behyavior among Adults with Severe Mental Illness|Persons with severe mental illness (SMI) are disproportionately affected by HIV/AIDS. This study examined multivariate correlates of sexual risk among 152 adults with SMI receiving outpatient psychiatric treatment. Structured interviews assessed psychiatric, psychosocial, and behavioral risk factors. The majority was sexually active (65%), and many reported unprotected intercourse (73%), multiple partners (45%), and sex trading (21%) in the past year. Logistic regression models found that sexual behaviors were differentially associated with non-psychotic disorder, psychiatric symptoms, substance abuse, childhood sexual abuse, romantic partnership, and social support (all ps < .05). Findings underscore the need for targeted HIV prevention interventions that address psychiatric and psychosocial risk factors. (Authors)|2|43|Community Mental Health Journal|153-169|NULL|Jul 11 2007 2:54PM|1|NULL|NULL|Meade, Christina;Sikkema, Kathleen;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://link.springer.com/article/10.1007/s10597-006-9071-6|[email protected]|NULL|NULL|6
26468|Treatment Adherence with Lithium and Anticonvulsant Medications among Patients with Bipolar Disorder|OBJECTIVE: Nonadherence limits the effectiveness of medications among patients with bipolar disorder. This study examined adherence with lithium and anticonvulsant medication among patients with bipolar disorder receiving treatment in Department of Veterans Affairs (VA) settings. METHODS: Patients receiving treatment in the VA for bipolar disorder during federal fiscal year 2003 (FY03) and receiving lithium or anticonvulsant medication were identified (N=44,637) by using the VA's National Psychosis Registry. Medication adherence was assessed by using the medication possession ratio (MPR) for lithium, valproate or divalproex, carbamazepine, and lamotrigine. Patients were categorized into three groups: fully adherent (MPR greater than .80), partially adherent (MPR from more than .50 to .80), and nonadherent (MPR less than or equal to .50). RESULTS: A slight majority of individuals (54.1%) were fully adherent, 24.5% were partially adherent, and 21.4% were nonadherent. Nonadherent individuals were more likely to be younger, unmarried, nonwhite, or homeless or to have diagnoses of a substance use disorder or fewer outpatient psychiatric visits in FY03. Adherence intensity was somewhat lower for valproate, compared with lithium or other anticonvulsants. Individuals given prescriptions for two agents to stabilize mood had better adherence than individuals given prescriptions for a single agent. Unexpectedly, in multivariate analyses adjusting for prior hospitalization, number of outpatient psychiatric visits, and a diagnosis of substance use disorder, poorer adherence was associated with decreased rates of hospitalization. CONCLUSIONS: Nearly one in two individuals given prescriptions for lithium or anticonvulsant medication to treat bipolar disorder did not take their medications as prescribed. The effectiveness of bipolar medication treatments is reduced by high rates of nonadherence in clinical settings (author).|6|58|Psychiatric Services|855-63|NULL|Jul 11 2007 3:14PM|1|NULL|NULL|Sajatovic, Martha;Valenstein, Marcia;Blow, Frederick;Ganoczy, Dara;Ignacio, Rosalinda;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://ps.psychiatryonline.org/journal.aspx?journalid=18|NULL|NULL|NULL|6
26469|The Role of Neurocognition and Social Context in Predicting Community Functioning Among Formerly Homeless Seriously Mentally Ill Persons|Objective: To test the influence of neurocognitive functioning on community functioning among formerly homeless persons with serious mental illness and to determine whether that influence varies with social context, independent of individual characteristics. Methods: In metropolitan Boston, 112 persons in Department of Mental Health shelters were administered a neuropsychological test battery and other measures and then randomly assigned to empowerment-oriented group homes or independent apartments, as part of a longitudinal study of the effects of housing on multiple outcomes. Subjects’ case managers completed Rosen's 5-dimensional Life Skills Inventory at 3, 6, 12, and 18 months and subjects reported on their social contacts at baseline, 6, 12, and 18 months. Subject characteristics are controlled in the analysis. Results: Three dimensions of neurocognitive functioning—executive function, verbal declarative memory, and vigilance—each predicted community functioning. Better executive function predicted improved self-care and less turbulent behavior among persons living alone, better memory predicted more positive social contacts for those living in a group home, and higher levels of vigilance predicted improved communication in both housing types. Conclusion: Neurocognition predicts community functioning among homeless persons with severe mental illness, but in a way that varies with the social context in which community functioning occurs. (Authors)|NULL|NULL|Schizophrenia Bulletin|NULL|NULL|Jul 11 2007 3:19PM|1|NULL|NULL|Schutt, Russell;Siedman, Larry;Caplan, Brina;Martsinkiv, Anna;Goldfinger, Stephen;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://schizophreniabulletin.oxfordjournals.org/content/33/6/1388.abstra...|NULL|NULL|NULL|6
26471|Veterans Affairs Health System and Mental Health Treatment Retention Among Patients with Serious Mental Illness: Evaluating Accessibility and Availability|Objective. We examine the impact of two dimensions of access — geographic accessibility and availability — on VA health system and mental health treatment retention among patients with serious mental illness (SMI). Methods. Among 156,631 patients in the Veterans Affairs (VA) health care system with schizophrenia or bipolar disorder in fiscal year 1998 (FY98), we used Cox proportional hazards regression to model time to first 12-month gap in health system utilization, and in mental health services utilization, by the end of FY02. Geographic accessibility was operationalized as straight-line distance to nearest VA service site or VA psychiatric service site, respectively. Service availability was assessed using county-level VA hospital beds and non-VA beds per 1,000 county residents. Patients who died without a prior gap in care were censored. Results. There were 32, 943 patients (21 percent) with a 12-month gap in health system utilization; 65,386 (42 percent) had a 12-month gap in mental health services utilization. Gaps in VA health system utilization were more likely if patients were younger, nonwhite, unmarried, homeless, nonservice-connected, if they had bipolar disorder, less medical morbidity, an inpatient stay in FY98, or if they lived farther from care or in a county with fewer VA inpatient beds. Similar relationships were observed for mental health, however being older, female, and having greater morbidity were associated with increased risks of gaps, and number of VA beds was not significant. Conclusions. Geographic accessibility and resource availability measures were associated with long-term continuity of care among patients with SMI. Increased distance from providers was associated with greater risks of 12-month gaps in health system and mental health services utilization. Lower VA inpatient bed availability was associated with increased risks of gaps in health system utilization. Study findings may inform efforts to improve treatment retention.(Authors)|3|42|Health Services Research|1042-1060|NULL|Jul 11 2007 3:33PM|1|NULL|NULL|McCarthy, John;Blow, Frederick;Valenstein, Marcia;Fischer, Ellen;Owen, Richard;Barry, Kristen;Hudson, Teresa;Ignacio, Rosalinda;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://onlinelibrary.wiley.com/|NULL|NULL|NULL|6
26472|Intensive Case Management as a Jail Diversion Program for People with a Serious Mental Illness- A Review of the Literature|This article reviews the research on intensive case management (ICM) programs as a jail diversion intervention for people with a serious mental illness (SMI). The review includes two types of ICM programs: (a) general ICM programs that included an assessment of arrests and incarceration rates for people with an SMI and (b) ICM programs specifically implemented as a component of a jail diversion intervention for people with an SMI. Results indicate that general ICM programs (19) rarely led to reductions in jail or arrest rates over time, and these rates were similar to those found in standard mental health services. General ICM programs that included an integrated addiction treatment component (8) had mixed results but a trend toward reductions in rates of arrests and incarceration over time for individuals with an SMI and a co-occurring substance use disorder. Results were mixed for jail diversion interventions with an ICM program, but most ICM programs (8) led to significant reductions in arrests and incarcerations over time. Specific elements of effective ICM jail diversion programs are discussed. (Authors)|2|51|International Journal of Offender Therapy and Comparative Criminology|130-150|NULL|Jul 11 2007 3:38PM|1|NULL|NULL|Loveland, David;Boyle, Michael;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://ijo.sagepub.com/content/51/2/130.abstract|NULL|NULL|NULL|6
26474|A Repeated Observation Approach for Estimating the Street Homeless Population|Risks of life on the street caused by inclement weather, harassment, and assault threaten the unsheltered homeless population. We address some challenges of enumerating the street homeless population by testing a novel capture-recapture (CR) estimation approach that models individuals' intermittent daytime visibility. We tested walking and vehicle-based variants of CR in downtown Toronto in March. Estimates that assume individual variability of sighting probabilities are most consistent with our knowledge of the homeless and achieve the most favorable confidence intervals, estimated detection probabilities, and coefficient of variation. Estimation bias from interobserver discrepancies, duplicate counting, and violation of the closed population assumption were minimized with uniform identification criteria, training, and sampling design. Bias caused by the social grouping of the homeless was small. Despite the limitations of visual identification, CR approaches as part of a multiple-method program can aid community responses to immediate needs on the street, especially during the harsh winter months. (Author)|2|31|Evaluation Review|166-199|NULL|Jul 11 2007 3:45PM|1|NULL|NULL|Berry, Brent;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://erx.sagepub.com/content/31/2/166.abstract|NULL|NULL|NULL|6
26475|Students' Experiences of Nursing Presence With Poor Mothers|An awareness of the health impact of poverty is core to effective nursing practice. Consequently, a clinical course for nursing students, the focus of which was the impact of poverty upon mental, physical, and spiritual health, was developed and implemented. As the students’ understanding of poverty developed, they appreciated that a nurse’s spirituality and nursing presence can empower poor and marginalized mothers. Nursing presence can provide a vital form of support for poor childbearing women that may reduce risk of poor birth outcomes (author).|2|36|Journal of Obstetric Gynoecologic and Neonatal Nursing|183-189||Jul 11 2007 3:54PM|1|NULL|NULL|DeLashmutt, Mary;|||NULL||48||0|NULL|NULL|http://onlinelibrary.wiley.com/|||NULL|6
26476|Being in Another World: Transcultural Student Experiences Using Service Learning with Families who are Homeless|Developing skills in cultural competence is a recognized theoretical strategy in schools of nursing. Nursing faculty know that students need to be sensitized to the concept of diversity; however, many are struggling with the best way to teach cultural competence. This article describes transcultural experiences from service learning clinical rotations at a family homeless shelter, described by students as being in another world. Student narratives provide valuable information about structuring clinical learning activities to promote understanding of cultural differences and similarities. Clinical experiences using a traditional model versus those using service learning, the role of reflection, and teaching strategies promoting transcultural learning through service learning are explored. (Authors)|2|18|Journal of Transcultural Nursing|167-174|NULL|Jul 11 2007 3:57PM|1|NULL|NULL|Hunt, Roberta;Swiggum, Paula;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://tcn.sagepub.com/content/18/2/167.abstract|NULL|NULL|NULL|6
26477|Receipt of Disability Through an Outreach Program for Homeless Veterans|Receipt of public support payments is associated with beneficial outcomes for homeless people with mental illness. The purpose of this study was to identify factors associated with receipt of Department of Veterans Affairs (VA) pension and compensation benefits among homeless veterans after their initial contact with the VA national homeless outreach program. We examined data for 5,731 veterans who were contacted by the program during the first 3 months of fiscal year 2003 and who were not receiving VA benefits, and we documented their benefit status over a minimum of 18 months. A limited number of veterans (15%) were subsequently awarded benefits; they were more likely to have reported recent use of VA services and a greater number of medical and psychiatric problems at the time of outreach. Findings suggest that VA benefit outreach efforts may gain from increased focus on those most vulnerable and most on the outskirts of the VA system. (Authors)|5|172|Military Medicine|461-465|NULL|Jul 13 2007 2:54PM|1|NULL|NULL|Greenberg, Greg;Chen, Joyce;Rosenheck, Robert;Kasprow, Wesley;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://www.ingentaconnect.com/content/amsus/zmm/2007/00000172/00000005/a...|NULL|NULL|NULL|6
26478|Fact sheet: Homeless Lesbian, Gay, Bisexual and Transgender (LGBT) Youth in Atlanta, Georgia|A brief fact sheet with some statistics and contact info regarding GLBT youth in Atlanta, GA. (HRC)||||||Jul 16 2007 9:30AM|0|NULL||NULL|National Gay and Lesbian Task Force||2006|Washington, D.C.|48||0|NULL|NULL|http://www.thetaskforce.org/downloads/reports/fact_sheets/HomelessYouthA...|||NULL|31
26479|Fact Sheet: Homeless Lesbian, Gay, Bisexual and Transgender (LGBT) Youth in Boston, Massachusetts|A brief fact sheet with some statistics and contact info regarding GLBT youth in Boston, MA. (HRC)||||||Jul 16 2007 9:37AM|0|NULL||NULL|National Gay and Lesbian Task Force||2006|Washington, D.C.|48||0|NULL|NULL|http://thetaskforce.org/downloads/reports/fact_sheets/HomelessYouthBosto...|||NULL|31
26480|Fact Sheet: Homeless Lesbian, Gay, Bisexual and Transgender (LGBT) Youth in Chicago Illinois|A brief fact sheet with some statistics and contact info regarding GLBT youth in Chicago, IL. (HRC)||||||Jul 16 2007 9:39AM|0|NULL||NULL|National Gay and Lesbian Task Force||2006|Washington, D.C.|48||0|NULL|NULL|http://thetaskforce.org/downloads/reports/fact_sheets/HomelessYouthChica...|||NULL|31
26481|Fact sheet: Homeless Lesbian, Gay, Bisexual and Transgender (LGBT) Youth in Denver, Colorado|A brief fact sheet with some statistics and contact info regarding GLBT youth in Denver, CO. (HRC)||||||Jul 16 2007 9:42AM|0|NULL||NULL|National Gay and Lesbian Task Force||2006|Washington, D.C.|48||0|NULL|NULL|http://thetaskforce.org/downloads/reports/fact_sheets/HomelessYouthDenve...|||NULL|31
26482|Fact sheet: Homeless Lesbian, Gay, Bisexual and Transgender (LGBT) Youth in Detroit, Michigan|A brief fact sheet with some statistics and contact info regarding LGBT youth in Detroit, MI. (HRC)||||||Jul 16 2007 9:44AM|0|NULL||NULL|National Gay and Lesbian Task Force||2006|Washington, D.C.|48||0|NULL|NULL|http://thetaskforce.org/downloads/reports/fact_sheets/HomelessYouthDetro...|||NULL|31
26483|Fact sheet: Homeless Lesbian, Gay, Bisexual and Transgender (LGBT) Youth in Florida|A brief fact sheet with some statistics and contact info regarding LGBT youth in Florida. (HRC)||||||Jul 16 2007 9:46AM|0|||The National Gay and Lesbian Task Force; |National Gay and Lesbian Task Force||2006|Washington, D.C.|48||0|NULL|NULL|http://thetaskforce.org/downloads/reports/fact_sheets/HomelessYouthFlori...|||NULL|31
26484|Fact sheet: Homeless Lesbian, Gay, Bisexual and Transgender (LGBT) Youth in Los Angeles, California|A brief fact sheet with some statistics and contact info regarding LGBT youth in Los Angeles, CA. (HRC)||||||Jul 16 2007 9:48AM|0|NULL||NULL|National Gay and Lesbian Task Force||2006|Washington, D.C.|48||0|NULL|NULL|http://thetaskforce.org/downloads/reports/fact_sheets/HomelessYouthLosAn...|||NULL|31
26485|Fact sheet: Homeless Lesbian, Gay, Bisexual and Transgender (LGBT) Youth in New York|A brief fact sheet with some statistics and contact info regarding LGBT youth in New York. (HRC)|NULL|NULL|NULL|NULL|NULL|Jul 16 2007 9:50AM|0|NULL|NULL|NULL|National Gay and Lesbian Task Force|NULL|2006|Washington, D.C.|48|NULL|0|NULL|NULL|http://thetaskforce.org/downloads/reports/fact_sheets/HomelessYouthNewYo...|NULL|NULL|NULL|31
26486|Fact sheet: Homeless Lesbian, Gay, Bisexual and Transgender (LGBT) Youth in San Francisco, California|A brief fact sheet with some statistics and contact info regarding LGBT youth in San Francisco, CA. (HRC)||||||Jul 16 2007 9:51AM|0|NULL||NULL|National Gay and Lesbian Task Force||2006|Washington, D.C.|48||0|NULL|NULL|http://thetaskforce.org/downloads/reports/fact_sheets/HomelessYouthSanFr...|||NULL|31
26487|Lesbian, Gay, Bisexual and Transgender Youth: An Epidemic of Homelessness: Press Conference|Of the estimated 1.6 million homeless American youth, between 20 and 40 percent identify as lesbian, gay, bisexual or transgender (LGBT). Why do LGBT youth become homeless? In one study, 26 percent of gay teens who came out to their parents/guardians were told they must leave home; LGBT youth also leave home due to physical, sexual and emotional abuse. Homeless LGBT youth are more likely to: use drugs, participate in sex work, and attempt suicide. Also, LGBT youth report they are threatened, belittled and abused at shelters by staff as well as other residents. (National Gay and Lesbian Task Force)||||||Jul 16 2007 9:53AM|0||||National Gay and Lesbian Task Force||2006|Washington, D.C.|48||0|NULL|NULL|http://www.thetaskforce.org/downloads/HomelessYouth.pdf|||NULL|25
26489|Documenting Attitude Changes Towards Homeless People: Comparing Two Standardised Surveys|Context: Curricula about the care of homeless patients have been developed to improve stigmatising attitudes towards patients living in poverty. The Attitudes Toward Homelessness Inventory (ATHI) and the Attitudes Towards the Homeless Questionnaire (ATHQ) are both validated instruments developed to assess attitudes towards homeless patients. Although these surveys have similar goals, it is not clear which is superior for documenting attitude changes among doctors in training. Methods: Seven cohorts of Year 2 and 3 primary care internal medicine residents at an urban public hospital in the USA completed the ATHI and ATHQ in a confidential manner before and after a 2-week rotation on health care for homeless patients (n = 25). Results: Both the ATHI (P < 0.001) and the ATHQ (P = 0.050) documented changes in residents' attitudes. The magnitude of the pre/post change was 0.63 per item for the ATHI and 0.13 per item for the ATHQ. When the ATHI per-item change was standardised to reflect the change that would be expected if there were 5 response choices instead of 6, the per-item change for the ATHI was 4.1-fold greater than for the ATHQ (P = 0.001). Residents improved their responses to 1 of every 8 statements on the ATHQ and 1 of every 2 statements on the ATHI after the course. Conclusions: Both the ATHI and the ATHQ documented improvement in residents' attitudes after a 2-week homeless medicine curriculum. However, the ATHI was 4 times more responsive to change. These findings suggest that the ATHI is superior for detecting changes in attitudes after an educational intervention. (Authors)|4|41|Medical Education|346-348|NULL|Jul 16 2007 10:21AM|1|NULL|NULL|Buchanan, David;Rohr, Louis;Stevak, Lisa;Sai, Theophilus;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://onlinelibrary.wiley.com/|[email protected]|NULL|NULL|6
26490|Service-Learning: An Eye-Opening Experience That Provokes Emotion and Challenges Stereotypes|Descriptive phenomenology was used to explore the lived experience of nursing students in service-learning clinical placement working with families who are homeless. Fourteen students from two different service-learning courses involving a family homeless shelter participated in the interviews. Six constituent descriptions were identified from thematic analysis: eye-opening to realize the effects of homelessness on families; feeling intense emotions that are sometimes hard to express; realizing families who are homeless are both different from and similar to families who have housing; challenging and transforming assumptions, perceptions, and stereotypes; the importance of reflection; and discovering new and different aspects of the nursing role. This research contributes to existing knowledge about the relationships between service-learning and emotional learning, cross-cultural learning, transformational learning, and developing caring as a way of being, as well as provides valuable information about improving service-learning activities. (Author)|6|46|The Journal of Nursing Education|277-281||Jul 16 2007 10:24AM|1|||Hunt, Roberta; |||2007||48||0|NULL|NULL|http://www.ncbi.nlm.nih.gov/pubmed/17580740|[email protected]||NULL|6
26492|Oral Health Needs of the Homeless|Aim: The aim was to assess the oral health needs of a homeless population residing in North and West Belfast Health and Social Services Trust area, in order to determine levels of unmet need and allow recommendations for service delivery to be made. Method: A sample of single homeless people was gathered using a snowballing sampling technique. Fourteen hostels located in North and West Belfast were visited in tandem with the homeless healthcare co-ordinator. All consenting participants were asked to complete a detailed medical history questionnaire and a questionnaire to assess their health and psycho-social needs, dental anxiety and oral health-related quality of life. All participants received an oral examination. Results: Three hundred and seventeen homeless people consented to take part. Two hundred and sixty-seven (84%) were male. Thirty-three percent of participants had mental health problems including psychotic illness, depression and anxiety. Forty-three percent of the sample stated they were addicted to alcohol and 3% were registered injecting drug users. Five percent (16) of the sample had soft tissue swellings of which two were found to be oral cancer. The participants had a mean D3cvMFT of 16.16 (95% CI: 15.71, 17.46). Seventy-five percent of the sample had bleeding gums and calculus; however only 4% had pocket depths of 6 mm or more. Dental anxiety status was related to dental disease experience which impacted negatively on quality of life. Forty-seven percent of the participants felt at least occasionally self-conscious and/or felt ashamed by the appearance of their teeth. Conclusions: Health and psychosocial factors associated with being homeless must be incorporated into the delivery of context-sensitive oral healthcare for this socially excluded population. (Authors)|12|202|British Dental Journal|742-743|NULL|Jul 16 2007 10:39AM|1|NULL|NULL|Collins, James;Freeman, Ruth;|NULL|NULL|2007|NULL|48|NULL|0|NULL|NULL|http://status.nature.com/|[email protected]|NULL|NULL|6
26493|Factors Identifying High-Frequency and Low-Frequency Health Service Utilization Among Substance-Using Adults|Understanding why substance-using patients seek care at emergency departments (EDs) and who utilizes such service at high rates is important in tailoring and targeting interventions. We conducted a retrospective/prospective cohort study of 326 medically ill substance-using adults to identify factors associated with 12-month high-frequency utilization of ambulatory care, ED, and inpatient medical care. The majority were actively using heroin (74.6%), cocaine (62.4%), and alcohol (54.4%); 94.8% had a chronic medical condition; and 53.8% reported a chronic mental health condition. High-frequency use of ED (= 3 visits) was independently associated with being female (adjusted odds ratio [AOR] = 1.88; 95% confidence interval [95% CI] = 1.12, 3.17), being African American (AOR = 2.36; 95% CI = 1.30, 4.29), being homeless (AOR = 2.07; 95% CI = 1.08, 3.96), a history of > 1 substance abuse treatment episode (AOR = 4.10; 95% CI = 3.28, 10.87), and = 1 ambulatory care visit (AOR = 8.94; 95% CI = 3.28, 24.41). However, the combination of having certain chronic conditions (seizure disorder, hepatitis B, and hepatitis C) and accessing ambulatory care was protective against high-frequency use of ED. In contrast, high-frequency use of ambulatory care (= 3 visits) was independently associated with having insurance (Medicare/Medicaid: AOR = 2.39; 95% CI = 1.31, 4.69), having HIV/AIDS (AOR = 3.15; 95% CI = 1.70, 5.85), and receiving substance abuse treatment during the study period (AOR = 3.58; 95% CI = 1.61, 7.98) Efforts to redirect medical care to more subacute settings will likely require both capacity building and addressing a client's underlying needs, including homelessness, access to substance abuse treatment, and chronic disease management. (Authors)|1|33|Journal of Substance Abuse Treatment|51-59|NULL|Jul 16 2007 10:46AM|1|NULL|NULL|OToole, Thomas;Pollini, Robin;Gray, Paulette;Jones, Theodore;Bigelow, George;Ford, Daniel;

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