Oral History as a Source for the Interpretation of UBH: The World War II Shelters in Naples Case Study

What can be the contribution of oral history to the interpretation of tangible cultural assets? Starting from this conceptual question, this article focuses on the case study of the experiences Second World War in Naples bomb shelters, recently included within the Underground Built Heritage (UBH) class. The hypothesis of the research is that bomb shelters are very significant elements in the subsoil of Naples but that, due to the lack of distinctive elements and dedicated storytelling, they are only partially exploited in the context of urban parks or generic itineraries Naples's subsoil. The thesis of the research is that the memories of those children that took refuge there during World War II (WWII), which were collected with the adoption of the oral history methodology, can integrate their value as elements of local cultural heritage and eventually support their interpretation for the benefit of the new generations. The methodology adopted was the collection, via structured and unstructured interviews, of the direct testimonies of those who took refuge in Naples' underground during the alarms. Twenty-three interviews were carried out, and all the issues introduced have been classified according to the various themes addressed during the narration in order to allow the reconstruction of dedicated storytelling in the future. The research was carried out immediately after the acute phase of the COVID-19 pandemic, an event that claimed many victims belonging to the generation of our witnesses, whose memories were at risk of being lost forever. © 2023 by the author.

Long-Term Urban Epidemic and Disaster Resilience: The Planning and Assessment of a Comprehensive Underground Resilience Core

This study utilizes the enclosed and stable environment of underground space for long-term sustainable planning for urban epidemics and disasters. Owing to the COVID-19 epidemic, cities require long-term epidemic-disaster management. Therefore, this study proposed a strategy for integrating multiple functions to plan a comprehensive Underground Resilience Core (URC). A planning and assessment methods of URC were proposed. With this methodology, epidemic- and disaster- URCs were integrated to construct a comprehensive-URC in underground spaces. The results show: (1) Epidemic-resilient URCs adopting a joint progressive approach with designated hospitals can rapidly suppress an epidemic outbreak. (2) The regularity of the morphology of underground spaces determines the area of the URC. Bar-shaped underground spaces have the potential for planning disaster-URCs. (3) The URC planning efficiency ranking is as follows: Bar shapes lead overall, T shapes are second under seismic resilience, and Cross shapes are second under epidemic resilience. (4) The potential analysis of planning a comprehensive-URC in the underground parking in Chinese cities showed that the recovery time can be advanced from 29% to 39% and the comprehensive resilience can be improved by 37.63%. The results of this study can serve as sustainable urban planning strategies and assessment tools for long-term epidemic-disaster management.

Shared Spaces, Shared Suffering: Exploring the Effects of COVID-19 on Urban Animal Advocacy Organizations in Chicago and Kansas City, USA

COVID-19‘s impact on the daily lives of millions of urban residents around the world has been significant, yet next to many humans are companion animals who have shared the "lockdown” experience. Much as the pandemic has upended human socio-economic lives, the pandemic has also upended companion animal lives, as well as the organizations working to help them in urban areas. This chapter, grounded in the perspective of animal geography, explores the positive and negative effects of COVID-19 on three U.S. animal advocacy organizations: two in Chicago, Illinois and one in Kansas City, Missouri. From early lockdown closures that temporarily stopped all direct care and outreach services, to a post-lockdown recognition of the increasing need for economic support to help families care for their companion animals, to the time lost managing feral populations, we show that the impact of COVID-19 cannot be seen as purely a human phenomenon, but must be seen as a more-than-human experience with long-term ramifications for human-animal relations in urban areas and beyond. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Shifting from Economic Poverty to Prosperity: The Challenge for Indigenous Communitie: Revue Canadienne de Recherche sur les OSBL et l'Économie Sociale (ANSERJ)

Only three self-funded second- stage women's shelters in First Nation communities were found in Canada. [...]maps show that no community foundations are available on reserves in Manitoba. Under the circumstances, the inequitable playing field that Canada has set up for First Nation communities, through the Indian Act and Canada Revenue Agency rules among others, is hidden from sight. [...]the role of the social economy in the settler state is never questioned or changed. [...]the social inequities rampant in Indigenous communities are never exposed or dealt with. First Nations include few or no community foundations, community colleges, notfor- profit training centers, and food banks. [...]rather than First Nations people controlling their own land and territories, the Crown holds land and resources in trust under the Indian Act.

Mental health symptoms among homeless shelter residents during COVID-19 lockdown in Tshwane, South Africa.

BACKGROUND: In order to contain the spread of COVID-19 in South Africa during the national state of emergency, the Gauteng Department of Social Development established temporary shelters and activated existing facilities to provide basic needs to street-homeless people in Tshwane, which facilitated primary health care service-delivery to this community. AIM: This study aimed to determine and analyse the prevalence of mental health symptoms and demographic characteristics among street-homeless people living in Tshwane's shelters during lockdown. SETTING: Homeless shelters set up in Tshwane during level 5 of the COVID-19 lockdown in South Africa. METHODS: A cross-sectional, analytical study was conducted using a Diagnostic and Statistical Manual of Mental Disorders (DSM-5)-based questionnaire that looked at 13 mental health symptom domains. RESULTS: Presence of moderate-to-severe symptoms were reported among the 295 participants as follows: substance use 202 (68%), anxiety 156 (53%), personality functioning 132 (44%), depression 85 (29%), sleep problems 77 (26%), somatic symptoms 69 (23%), anger 62 (21%), repetitive thoughts and behaviours 60 (20%), dissociation 55 (19%), mania 54 (18%), suicidal ideation 36 (12%), memory 33 (11%) and psychosis 23 (8%). CONCLUSION: A high burden of mental health symptoms was identified. Community-oriented and person-centred health services with clear care-coordination pathways are required to understand and overcome the barriers street-homeless people face in accessing health and social services.Contribution: This study determined the prevalence of mental health symptoms within the street-based population in Tshwane, which has not previously been studied.

Effectiveness of rapid immunochromatographic tests to the detection of feline Coronavirus

Feline coronavirus (FCoV) belongs among pathogens with common occurrence in the cats population in the whole world. FCoV is ubiquitous in environments with a higher concentration of cats, e.g. in shelters, multicat households and kennels. FCoV primarily attacks the digestive feline tract, replicates in its cells and is excreted in the feces to surroundings of permanently or transiently infected cats. The aim of the study was the detection of FCoV in the feces of newly admitted cats to the shelter by the qPCR method and by means of commercial rapid immunochromatographic (antigen) tests from three different producers. For each of the antigen tests, sensitivity and specifity were determined by comparison with the qPCR analysis result. Out of 70 examined fecal samples, viral RNA was by the qPCR analysis identified in 44 samples (62.9%). Neither the age nor the gender of cats played a significant role in the viral excretion. Found sensitivity of the antigen tests was at a low (< 35%;tests A and C) to a satisfactory level (> 50%, test B). The number of viral particles in the samples determined by the qPCR method did not correlate significantly with the result of the antigen tests. The results of this study suggest that the use of rapid antigen tests for routine screening of FCoV shedding in feline shelters is limited due to the high rate of false-negative results.

The Etymology of Despair in the Americas

Halfway into White Noise, Don DeLillo's novel from 1985, Jack Gladney packs his family in the car and leaves town running from a black chemical cloud. The "airborne toxic event” had triggered an emergency evacuation plan: floodlights from helicopters, sirens, unmarked cars from obscure agencies, clogged roads, makeshift shelters at a Boy Scout camp where the Red Cross would dispense juice and coffee. People are confused, they seek information wherever they can, "[s]mall crowds collected around certain men.” Among generalized bewilderment, Gladney observes a few individuals moving faster and more assertively than the rest, then getting into a Land Rover. In the chaotic scene of crisis, their confidence gets his attention. "Their bumper stickers read GUN CONTROL IS MIND CONTROL” Gladney reads. And his mind wanders: "In situations like this, you want to stick close to people in right-wing fringe groups. They've practiced staying alive.”

The use of nonpharmacutical interventions in the prevention of COVID-19 in people experiencing homelessness in emergency shelters

The virus responsible for COVID-19, acknowledged as a public health threat, has been causing global disease since first discovered in December 2019 in China. The CDC (2021) issued a call for action through its Science Agenda for COVID-19 to identify evidence-based interventions for interrupting disease progression in vulnerable populations such as those in emergency shelter settings.This project focused on COVID-19 and its impact on the homeless population in northwestern Pennsylvania. The theoretical framework was the Johns Hopkins Evidence-Based Practice Model (JHEBP). A survey collected self-reported data on the practice and barriers to using personal NPIs. Participants were adults ages 18 years or older residing in one of two emergency shelters on the data collection date.The Questionnaire to Assess Preventative Practices Against the COVID-19 Pandemic in the General Population was modified to facilitate its use in an emergency shelter setting in the United States. Surveys were distributed to 142 individuals over the four data collection times;28% were returned with 93% complete.The preventative measures used by the participants most often were covering the face when sneezing or coughing and maintaining social distancing. Barriers to not following the recommendations included time, overcrowding, and personal opinion.A variety of toolkits are available to assist in developing the continued education identified as a need for the homeless. Future research, including focus groups and observation, can add to the knowledge base of COVID-19 and the homeless. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The epidemiological follow-up process for suspected and confirmed cases of COVID-19 in migrant shelters on the northern border of Mexico from July to December 2020: Between contagion underestimation and containment.

Background: Elements associated with an increased risk factor for the contagion of COVID-19 in shelters include the turnover and overcrowding of people, time spent in communal areas, daily supply needs, water availability, and sanitation levels. The "Report on the Effects of the COVID-19 Pandemic on Migrants and Refugees," shows that factors such as the shortage of food, supplies, water, sanitizing materials, spaces for healthy distancing, financial resources for rent and essential services, and the lack of medical or psychological care complicated providing care for migrants and applicants seeking international protection. Objective: We describe shelter operations regarding the detection and follow-up of suspected and confirmed COVID-19 cases showing mild symptoms among the migrant population housed in the border cities under study. Methods: We conducted semi-structured, in-depth interviews with study subjects (people in charge, managers, coordinators, shelter directors) from 22 migrant shelters, and 30 with key informants. We studied the cities of Tijuana (Baja California), Nogales (Sonora), Ciudad Juárez (Chihuahua), Piedras Negras (Coahuila), and Heroica Matamoros (Tamaulipas). The research was based on a qualitative methodological design with an ethnographic approach. The information collected was transcribed and systematized into two tables or analytical templates, one for interviews with study subjects, and another for interviews with key actors. Findings: Overall, seventy-eight registered shelters provided accommodation services for migrants in the five cities the study focused on: thirty-seven in Tijuana, five in Nogales, twenty-two in Ciudad Juárez, eight in Piedras Negras, and five plus a camp (six in total) in Matamoros. The major concentration of shelters was in Tijuana (47.4%) and Ciudad Juárez (28.2%). At the beginning of the pandemic, only a few shelter facilities met quarantine and isolation guidelines, such as having separate bathrooms and sufficient space to isolate the "asymptomatic" and "confirmed" from close "contacts". The lack of isolation space and the inability to support the monitoring of patients with COVID-19 posed a challenge for those housed in shelters, forcing many shelters to close or continue operating behind closed doors to avoid becoming a source of infection during the pandemic. Discussion and outlook: Contrary to speculation, during the onset of the pandemic northern border migrant shelters did not become sources of COVID-19 infection. According to the data analyzed from 78 shelters only seven had confirmed cases, and the classification of "outbreak" was applied only in two facilities. Contagion control or containment was successful as the result of following a preventive containment logic, including the isolation of all suspected but unconfirmed cases, without a clear understanding of the human and financial resources required to maintain isolation areas. However, shelters in the study implemented protocols for epidemiological surveillance, control, and prevention with elements that interfered with monitoring spaces, and processes that caused oversights that resulted in underestimating the number of cases. Limitations: Due to travel restrictions imposed to prevent and contain coronavirus infections it was impossible to stay on-site in the cities studied, except for Tijuana, or carry-out recordings of migrants' views in shelters.

Respiratory infectious disease outbreaks among people experiencing homelessness: a systematic review of prevention and mitigation strategies.

PURPOSE: People experiencing homelessness (PEH) are at increased risk of respiratory infections and associated morbidity and mortality. To characterize optimal intervention strategies, we completed a systematic review of mitigation strategies for PEH to minimize the spread and impact of respiratory infectious disease outbreaks, including COVID-19. METHODS: The study protocol was registered in PROSPERO (#2020 CRD42020208964) and was consistent with the preferred reporting in systematic reviews and meta-analyses guidelines. A search algorithm containing keywords that were synonymous to the terms "Homeless" and "Respiratory Illness" was applied to the six databases. The search concluded on September 22, 2020. Quality assessment was performed at the study level. Steps were conducted by two independent team members. RESULTS: A total of 4468 unique titles were retrieved with 21 meeting criteria for inclusion. Interventions included testing, tracking, screening, infection prevention and control, isolation support, and education. Historically, there has been limited study of intervention strategies specifically for PEH across the world. CONCLUSIONS: Staff and organizations providing services for people experiencing homelessness face specific challenges in adhering to public health guidelines such as physical distancing, isolation, and routine hygiene practices. There is a discrepancy between the burden of infectious diseases among PEH and specific research characterizing optimal intervention strategies to mitigate transmission in the context of shelters. Improving health for people experiencing homelessness necessitates investment in programs scaling existing interventions and research to study new approaches.

The clinical and genomic epidemiology of seasonal human coronaviruses in congregate homeless shelter settings: A repeated cross-sectional study.

Background: The circulation of respiratory viruses poses a significant health risk among those residing in congregate settings. Data are limited on seasonal human coronavirus (HCoV) infections in homeless shelter settings. Methods: We analysed data from a clinical trial and SARS-CoV-2 surveillance study at 23 homeless shelter sites in King County, Washington between October 2019-May 2021. Eligible participants were shelter residents aged ≥3 months with acute respiratory illness. We collected enrolment data and nasal samples for respiratory virus testing using multiplex RT-PCR platform including HCoV. Beginning April 1, 2020, eligibility expanded to shelter residents and staff regardless of symptoms. HCoV species was determined by RT-PCR with species-specific primers, OpenArray assay or genomic sequencing for samples with an OpenArray relative cycle threshold <22. Findings: Of the 14,464 samples from 3281 participants between October 2019-May 2021, 107 were positive for HCoV from 90 participants (median age 40 years, range: 0·9-81 years, 38% female). HCoV-HKU1 was the most common species identified before and after community-wide mitigation. No HCoV-positive samples were identified between May 2020-December 2020. Adults aged ≥50 years had the highest detection of HCoV (11%) among virus-positive samples among all age-groups. Species and sequence data showed diversity between and within HCoV species over the study period. Interpretation: HCoV infections occurred in all congregate homeless shelter site age-groups with the greatest proportion among those aged ≥50 years. Species and sequencing data highlight the complexity of HCoV epidemiology within and between shelters sites. Funding: Gates Ventures, Centers for Disease Control and Prevention, National Institute of Health.

Gestion punitive de l'itinérance durant la pandémie: Défis et stratégies des intervenant·e·s de première ligne à Montréal

Les personnes en situation d'itinérance (PSI) qui tentent de (sur)vivre dans les espaces publics vivent une judiciarisation accrue ainsi qu'un contrôle punitif qui se manifestent aussi dans les espaces de soins. Les intervenant·e·s de première ligne, dans les refuges ou dans la rue, ont des contacts fréquents avec la police. Les pratiques de profilage social et de contrôle punitif exercées sont largement documentées, mais des lacunes subsistent quant aux impacts de la pandémie de COVID-19 pour les intervenant·e·s et leurs usager·ère·s. Notre article rend compte d'une étude de cas menée à Montréal, fondée sur 43 entrevues semi-structurées portant sur les constats d'infraction liés aux mesures sanitaires, les campements et les agent·e·s de sécurité dans les refuges. En nous inspirant de la criminologie des crises ainsi que des études sur la gestion de l'itinérance, nous analysons les défis et les stratégies que les travailleur·euse·s de première ligne utilisent pour résister aux approches punitives. Notre étude aide à clarifier les conséquences de la gouvernance des espaces publics et de services durant la pandémie pour les intervenant·e·s et leurs usager·ère·s. Elle participe à une meilleure compréhension de la violence juridique, du contrôle punitif et de l'exclusion des populations marginalisées, tout en portant une attention particulière à la résilience du milieu communautaire et des intervenant·e·s de première ligne.Alternate :People experiencing homelessness (PEH) are pressed to survive both in public spaces, where they face intense judicialization and criminalization, as well as in spaces of care, where they also experience punitive governance. Frontline service providers, in shelters, or conducting street outreach, regularly engage with security forces and the police. The social profiling and punitive control of PEH has been widely documented, yet little is known about the impacts of the COVID-19 pandemic on key issues important to practitioners and their clients. Our paper reports on 43 semi-structured interviews conducted with Montreal practitioners, focusing on local themes such as COVID tickets, encampments, and increased security forces in shelters. Engaging with work on the punitive governance of homelessness and a criminology of crisis, we analyze how frontline workers face challenges while also pushing to adapt, innovate and resist punitive approaches. Our work can help clarify when and how pandemic-related laws, regulations, police practices, and agency rules impact practitioners and the people they work with. We contribute to a better understanding of the control, punishment and exclusion of PEH and of legal violence, while also focusing on community and frontline resilience.Alternate :Las personas si hogar intentado sobrevivir en los espacios públicos se enfrentan a una intensa judicialización y a un control punitivo que se manifiesta también en los espacios donde reciben asistencia. Los proveedores de servicios de primera línea, en los albergues o en la calle, tienen contacto frecuente con la policía. Las prácticas de elaboración de perfiles sociales y el control punitivo han sido ampliamente documentadas, pero las lagunas persisten en lo que se refiere al impacto que ha tenido la pandemia de COVID-19 sobre los trabajadores de primera línea y sus usuarios. Nuestro artículo presenta un estudio de caso llevado a cabo en Montréal, fundado sobre 43 entrevistas semiestructuradas sobre las multas por incumplimiento de medidas sanitarias, los campamentos y las fuerzas de seguridad en los albergues. Inspirándose en la criminología de las crisis y los estudios sobre la gestión de las personas sin techo, analizamos los desafíos y las estrategias que los trabajadores de primera línea utilizan para resistir ante los enfoques punitivos. Nuestro estudio ayuda a clarificar las consecuencias de la gobernanza de los espacios públicos y de los servicios durante la pandemia para dichos trabajadores y sus usuarios. Además, contribuy a una mejor comprensión de la violencia jurídica, del control punitive y de la exclusión de las personas marginalizadas, prestando especial atención a la resiliencia del sector comunitario y de los profesionales de primera línea.

COVID-19, usages de drogues et réduction des risques Analyse croisée des expériences et de l'impact de la pandémie en France et au Québec

Les personnes utilisatrices de substances qui fréquentent les services d'addictologie et de réduction des risques font partie des publics en situation de précarité dont les vulnérabilités sont aggravées en temps de pandémie. Notre article étudie l'expérience de la pandémie par ces personnes et l'impact de celle-ci sur les pratiques professionnelles et l'action publique, comme productrice d'inégalités mais aussi d'innovations et de solidarités. La collecte de données a été réalisée en France et au Québec, incluant des entretiens semi-directifs auprès de personnes usagères de substances (France, n = 25 ;Québec, n = 15) et de professionnels en addictologie et réduction des risques (France, n = 25 ;Québec, n = 18). Une approche théorique pragmatiste a été mise en oeuvre et analyse les niveaux macro et micro ensemble et de manière réflexive. Dès le premier confinement, les dispositifs professionnels ont tenté au mieux d'organiser une continuité de services afin de répondre aux besoins des usagers dans un contexte d'urgence sanitaire : par le déploiement de l'accès à l'hébergement, le développement de la téléconsultation afin d'assurer la continuité des soins. Des innovations ont été réalisées par des collaborations entre acteurs sur l'hébergement ou sur l'inclusion accélérée de la réduction des risques (alcool et approvisionnement sécuritaire) dans les centres d'hébergement. Des difficultés ont été également observées en lien avec des contraintes organisationnelles. Les usagers se sont bien approprié les mesures de prévention. Ils ont subi des logiques de contrôle social dans les champs sanitaire et répressif. Au-delà des vulnérabilités apportées par la COVID-19, des adaptations peuvent également constituer des opportunités de création de solidarités entre usagers et professionnels, des espaces favorables aux innovations professionnelles, et des nouveaux modes de collaboration et d'organisation entre acteurs.Alternate :People who use psychoactive substances and who attend drug treatment and harm reduction services represent groups whose vulnerabilities are exacerbated during a pandemic. We study the pandemic experience of people with problematic substance use and its impact on professional practices and policies, with an eye towards vulnerability and innovations. This comparative study was conducted in France and Quebec via semi-structured interviews with substance users (France, n=25 ;Quebec, n=15) and care and harm reduction providers (France, n=25 ;Quebec, n=18). We employ a pragmatist theoretical approach that reflexively analyzes the macro and micro levels together. During the first lockdown, professionals tried their best to organize a continuity of service to meet the needs of people in a context of a health emergency via the deployment of access to accommodation and the development of teleconsultation to ensure continuity of care. Innovative collaborations between actors occurred related to accommodation or the inclusion of harm reduction (alcohol and safe supply) in shelters. Difficulties were observed stemming from organizational constraints. Individuals adopted the preventive measures and had to endure social control both in the health and repressive fields. Beyond the vulnerabilities produced by COVID-19, adaptations also constitute opportunities for : solidarity between users and professionals, professional innovations, as well as new modes of collaboration and inter-actor organization.Alternate :Las personas que consumen sustancias y acuden a los servicios de adicción y reducción de riesgos se encuentran entre los grupos de población en situación de precariedad cuya vulnerabilidad se ha agravado durante la pandemia. Nuestro artículo estudia cómo estas personas han vivido la pandemia y el impacto de ésta en las prácticas profesionales y la acción pública, como productora de desigualdades, pero también de innovaciones y de solidaridad. La recogida de datos se llevó a cabo en Francia y en Quebec, incluyendo e trevistas semidirectivas con usuarios de sustancias (Francia, n=25 ;Quebec, n=15) y con profesionales del ámbito de la adicción y la reducción de riesgos (Francia, n=25 ;Quebec, n=18). Se utilizó un enfoque teórico pragmático, analizando conjuntamente los niveles macro y micro de forma reflexiva. Desde el primer confinamiento, los dispositivos profesionales trataron de organizar una continuidad de los servicios para responder a las necesidades de los usuarios en un contexto de emergencia sanitaria : se impulsó el acceso al alojamiento y se desarrolló la teleconsulta para garantizar la continuidad de los cuidados. Las innovaciones se han producido a través de la colaboración de los actores del sector del alojamiento o mediante la inclusión acelerada de la reducción de riesgos (alcohol y suministro seguro) en los centros de alojamiento. También se observaron dificultades en relación con las limitaciones organizativas. Los usuarios han integrado las medidas de prevención. Han sido sometidos a lógicas de control social en el ámbito sanitario y represivo. Más allá de las vulnerabilidades producidas por el COVID-19, las adaptaciones también pueden constituir oportunidades para la solidaridad entre usuarios y profesionales, espacios favorables a las innovaciones profesionales y nuevos modos de colaboración y organización entre los actores.

Results from a test-and-treat study for influenza among residents of homeless shelters in King County, WA: A stepped-wedge cluster-randomized trial.

BACKGROUND: Persons experiencing homelessness face increased risk of influenza as overcrowding in congregate shelters can facilitate influenza virus spread. Data regarding on-site influenza testing and antiviral treatment within homeless shelters remain limited. METHODS: We conducted a cluster-randomized stepped-wedge trial of point-of-care molecular influenza testing coupled with antiviral treatment with baloxavir or oseltamivir in residents of 14 homeless shelters in Seattle, WA, USA. Residents ≥3 months with cough or ≥2 acute respiratory illness (ARI) symptoms and onset <7 days were eligible. In control periods, mid-nasal swabs were tested for influenza by reverse transcription polymerase chain reaction (RT-PCR). The intervention period included on-site rapid molecular influenza testing and antiviral treatment for influenza-positives if symptom onset was <48 h. The primary endpoint was monthly influenza virus infections in the control versus intervention periods. Influenza whole genome sequencing was performed to assess transmission and antiviral resistance. RESULTS: During 11/15/2019-4/30/2020 and 11/2/2020-4/30/2021, 1283 ARI encounters from 668 participants were observed. Influenza virus was detected in 51 (4%) specimens using RT-PCR (A = 14; B = 37); 21 influenza virus infections were detected from 269 (8%) intervention-eligible encounters by rapid molecular testing and received antiviral treatment. Thirty-seven percent of ARI-participant encounters reported symptom onset < 48 h. The intervention had no effect on influenza virus transmission (adjusted relative risk 1.73, 95% confidence interval [CI] 0.50-6.00). Of 23 influenza genomes, 86% of A(H1N1)pdm09 and 81% of B/Victoria sequences were closely related. CONCLUSION: Our findings suggest feasibility of influenza test-and-treat strategies in shelters. Additional studies would help discern an intervention effect during periods of increased influenza activity.

Do wildfires exacerbate COVID-19 infections and deaths in vulnerable communities? Evidence from California.

Understanding whether and how wildfires exacerbate COVID-19 outcomes is important for assessing the efficacy and design of public sector responses in an age of more frequent and simultaneous natural disasters and extreme events. Drawing on environmental and emergency management literatures, we investigate how wildfire smoke (PM2.5) impacted COVID-19 infections and deaths during California's 2020 wildfire season and how public housing resources and hospital capacity moderated wildfires' effects on COVID-19 outcomes. We also hypothesize and empirically assess the differential impact of wildfire smoke on COVID-19 infections and deaths in counties exhibiting high and low social vulnerability. To test our hypotheses concerning wildfire severity and its disproportionate impact on COVID-19 outcomes in socially vulnerable communities, we construct a county-by-day panel dataset for the period April 1 to November 30, 2020, in California, drawing on publicly available state and federal data sources. This study's empirical results, based on panel fixed effects models, show that wildfire smoke is significantly associated with increases in COVID-19 infections and deaths. Moreover, wildfires exacerbated COVID-19 outcomes by depleting the already scarce hospital and public housing resources in local communities. Conversely, when wildfire smoke doubled, a one percent increase in the availability of hospital and public housing resources was associated with a 2 to 7 percent decline in COVID-19 infections and deaths. For California communities exhibiting high social vulnerability, the occurrence of wildfires worsened COVID-19 outcomes. Sensitivity analyses based on an alternative sample size and different measures of social vulnerability validate this study's main findings. An implication of this study for policymakers is that communities exhibiting high social vulnerability will greatly benefit from local government policies that promote social equity in housing and healthcare before, during, and after disasters.

Evaluation of dental demands and needs of people experiencing homelessness in the city of Rome, Italy

OBJECTIVE: Poor oral health and oral diseases are common among people experiencing homelessness. The aim of this study was to evaluate the dental demands and needs of a population of homeless persons in the city of Rome, Italy. PATIENTS AND METHODS: The clinical records of 165 homeless patients admitted between October 2020 and October 2021 to the dental service of the Primary Care Services of the Eleemosynaria Apostolica, Vatican City, were retrospectively reviewed. The service employed dentists to evaluate dental needs and oral conditions in patients experiencing homelessness. The main dental and oral pathological conditions were noted. RESULTS: One hundred and sixty-five records of homeless patients were included in the study. The sample consisted in 138 males (76.97%) and 27 females (23.03%) with a mean age of 46.9 years (range 7-85 years). Acute tooth pain was reported by 132 (80%) patients, 42 (25.45%) had edentulism or missing teeth and 18 (10.91%) patients had oral lesions. Both dental and oral pathologies were intercepted and managed in secondary health-care facilities. CONCLUSIONS: Given the specific peculiarities of this vulnerable population, it is import-ant to implement strategies that facilitate the access of persons experiencing homelessness to dental evaluation with a preventive and curative perspective.

COVID-19 prevalence and infection control measures at homeless shelters and hostels in high-income countries: a scoping review.

BACKGROUND: The COVID-19 pandemic has disproportionately impacted homeless populations and service workers, especially within homeless shelter/hostel settings. To date, there have been few evidence syntheses examining outbreaks of COVID-19 among both homeless shelter residents and service workers and no critical review of infection control and prevention (IPAC) measures. This scoping review offers a much-needed synthesis of COVID-19 prevalence within homeless shelters and a review of pertinent IPAC measures.  METHODS: We conducted a scoping review that aimed to synthesize academic and gray literature published from March 2020 to July 2021 pertaining to (1) the prevalence of COVID-19 among both residents and staff in homeless shelters and hostels in high-income countries and (2) COVID-19 IPAC strategies applied in these settings. Two reviewers independently screened the literature from several databases that included MEDLINE, PsycInfo, and the WHO's COVID-19 Global Health Portal. The extracted data was mapped, categorized, and thematically discussed. RESULTS: Thematic analysis of 77 academic and gray literature documents revealed four key themes: (1) the demographics of COVID-19 in homeless shelters, (2) asymptomatic spread, (3) pre-existing vulnerability of people experiencing homelessness and shelters, and (4) the inconsistency and ineffectiveness of IPAC implementation. CONCLUSION: This review offers a useful glimpse into the landscape of COVID-19 outbreaks in homeless shelters/hostels and the major contributing factors to these events. This review revealed that there is no clear indication of generally accepted IPAC standards for shelter residents and workers. This review also illustrated a great need for future research to establish IPAC best practices specifically for homeless shelter/hostel contexts. Finally, the findings from this review reaffirm that homelessness prevention is key to limiting disease outbreaks and the associated negative health outcomes in shelter populations. Limitations of this review included the temporal and database constraints of the search strategy, the exclusion of quality assessments of the literature, and the absence of investigation on the influence of emerging variants on public health policy. SYSTEMATIC REVIEW REGISTRATION: This scoping review has not been registered on any database; the protocol is available on York University's Institutional Repository https://dx.doi.org/10.25071/10315/38513 .

Human Parainfluenza Virus in Homeless Shelters before and during the COVID-19 Pandemic, Washington, USA.

To determine the epidemiology of human parainfluenza virus in homeless shelters during the COVID-19 pandemic, we analyzed data and sequences from respiratory specimens collected in 23 shelters in Washington, USA, during 2019-2021. Two clusters in children were genetically similar by shelter of origin. Shelter-specific interventions are needed to reduce these infections.

‘We have tried to remain warm despite the rules.’ Domestic violence and COVID-19: implications for shelters’ policies and practices

This article presents findings from a study that investigated the impacts of the COVID-19 pandemic on domestic violence shelters’ policies and practices. This study was conducted in partnership with feminist organisations in two regions in the Quebec, Canada. Qualitative data were collected from nine domestic violence shelters, using a web-based questionnaire. Thematic content analysis was conducted using NVivo. The research findings reveal that the COVID-19 pandemic has created significant challenges for shelters, as they have had to ensure women’s and children’s safety while preventing the spread of the virus. In this context, they have had to adapt their services and practices, and it has sometimes been difficult to maintain their feminist approach. Nonetheless, shelters have been creative and have developed multiple strategies to overcome these challenges and to ensure women’s and children’s access to services. The research findings contribute to our understanding of the impacts of the COVID-19 pandemic, and highlight the essential role that these organisations have played to ensure women’s and children’s safety at a time when they have been particularly vulnerable.

Tuberculosis: Common Questions and Answers

Approximately 10 million people worldwide were infected with tuberculosis (TB) in 2019, resulting in 1.4 million deaths. In the United States that same year, there were nearly 9,000 reported cases of TB disease and up to 13 million people were living with latent TB infection (LTBI), which is an asymptomatic, noncommunicable infection caused by Mycobacterium tuberculosis. Without treatment, LTBI will progress to active TB disease in approximately 5% to 10% of affected people. Individuals with symptoms of TB disease warrant testing. The U.S. Preventive Services Task Force recommends testing individuals at increased risk of LTBI with an interferon-gamma release assay or tuberculin skin testing. Because the incidence of LTBI in health care professionals is similar to that of the general population, periodic retesting is not recommended. After a positive test result, chest radiography should be performed and, in patients with suspected pulmonary TB disease, sputum collected for diagnosis. Both suspected and confirmed cases of LTBI and TB disease must be reported to local or state health departments. Preferred treatment regimens for LTBI include isoniazid in combination with rifapentine or rifampin, or rifampin alone for a duration of three and four months, respectively. Treatment of drug-susceptible TB disease includes an eight-week intensive phase with four drugs (isoniazid, rifampin, pyrazinamide, and ethambutol), followed by a continuation phase lasting 18 weeks or more, with two drugs based on susceptibility testing results. Consultation with a TB expert is necessary if there is suspicion or confirmation of drug-resistant TB. (Am Fam Physician. 2022;106(3):308–315. Copyright © 2022 American Academy of Family Physicians.)